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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 273 out of 8,010

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VAERS ID: 1719204 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Florida  
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 FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Chest pain, Electrocardiogram abnormal, Fatigue, Malaise, Pain, Palpitations, Sinus bradycardia
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 9/7/21 - XR Chest 2 Views FINDINGS: The cardiothymic silhouette is normal in size and configuration. The lungs are clear. No pleural effusions or pneumothorax are identified. The
CDC Split Type:

Write-up: 9/7/21 - Pt is a 13 y/o M with chest pain x 3 days. Mom reports the chest pain started after 2nd dose of covid vaccine. She reports he was having fatigue and tired over the weekend. She reports over the past 2 days he has had chest discomfort. He reports that it is worse when he is lying on his side. He has not had fever. no cough or congestion symptoms. He reports the pain was worse this morning and he took tylenol. Pain is not reproducible. 09/07/2021 17:40:00 MD, Peds cardiology, phone call, recommends no pericarditis on EKG. If worsening symptoms, go to ER. Otherwise, follow-up with Cardiology this week.Cardiology Office Outpatient 9/8/21 -P.T. is a previously healthy 13 y.o. male who presents today with mother referred by pediatrician for chest pain in the setting of receiving the Covid-19 vaccine on 09/04. P.T. reports being in his usual state of health and asymptomatic until receiving the vaccine 4 days ago. After that he felt tired with malaise and mild body aches that responded well to Tylenol. However, Sunday morning he woke up at 6 am with mid sternal chest pain described as burning, constant and worsening with a 7/10 intensity. No radiation. Worse with lying down supine and on his side. Improved with standing up and with Advil 600 mg q6hr. He endorses some headache and palpitations while having chest pain but denies dysphagia, odynophagia, dizziness, shortness of breath, sweating or fainting. At this time he is asymptomatic and no acute distress denies fever, cough, nasal congestion, discharge from the ears/nose/eyes, throat pain, diarrhea, constipation, joint/muscle pain or swelling. No sick contacts at home. No recent travel or known COVID exposure. VUTD. Timing of symptoms and EKG showing mild ST segment elevations is concerning for possible myopericarditis post Covid19 vaccination. Natural course of this symptoms is complete resolution with time and NSAIDs. Labs/Diagnostic Tests Continued: 9/7/21 - SINUS BRADYCARDIA, NORMAL AXIS, INTERVALS, and VOLTAGES, MINIMAL ANTERIOR T-WAVE CHANGES, LIKELY NORMAL VARIANT 9/8/21 - Echocardiogram Non Congenital Complete CONCLUSIONS: - No structural abnormalities seen. Normal valvular function. Qualitatively normal left ventricular systolic function. No significant pericardial effusion.


VAERS ID: 1719244 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
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 FC3183 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram normal, Extrasystoles, Feeling abnormal, Injected limb mobility decreased, Malaise, Nausea, Pain, Pain in extremity, Sensory loss, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Tendinopathies and ligament disorders (broad), Hypokalaemia (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: Bronchospasm, chest pain, covid-like symptoms, lt arm pain
Preexisting Conditions: Chronic hep c, rt knee pain, psoriasis, osteopenia, chronic apical periodontitis, unstable housing, tobacco use, post-traumatic osteoarthritis of rt knee, vitamin d deficiency, purse hypercholesterolemia
Allergies: NONE
Diagnostic Lab Data: CMP, CBC ordered on 9/15 did not do yet. EKG on 9/16 done in clinic was normal.
CDC Split Type:

Write-up: 9/15 phone appt w/ PCP: " left arm- phizer, covid vaccine 2 weeks ago. 24 hours later, left arm pain and not able to use as well since. Starts at neck, getting worse. Is able to move arm. Feels like heart skips a beat sometimes, with pain and SOB since then. Declines ER. Feels like a "guinea pig". Vaccine required by pool hall, "if there''s a fight, there''s a fight. If there''s blood, there''s blood". Refusing getting vaccine #2. Think he had delta variant for 3 weeks already 8/2021, declined testing at the time. " 9/16 Office visit FNP- "63 y.o. male c/o pain, n/v, and all covid symptoms, pt stated that he got the Covid Vaccine on 9/3/21 and has been experiencing severe L arm pain, loss of feeling in both hands, vomited for several hours on 9/11. Pt states he received a dose of COVID vaccine and 3 weeks later received a 2nd dose. Pt states he became very ill after second dose. Voices no other concerns."...Received Toradol 30mg 0.5ml IM inj. Was prescribed Albuterol Sulfate HFA Aerosol Solution, 108 (90 Base) MCG/ACT, 2 puff as needed, Inhalation, every 4-6 hrs as needed, 30 days, 1, Refills 3 Start Flovent HFA Aerosol, 110 MCG/ACT, 1 puff, Inhalation, Twice a day, 30 days, 1, Refills 2 Start predniSONE Tablet, 20 MG, 1 tablet, Orally, Once a day, 5 days, 5 Tablet.


VAERS ID: 1719245 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-27
Onset:2021-09-04
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: SOB no energy loss of appetite no cough


VAERS ID: 1719413 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
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 - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chest pain, Dyspnoea, Pain, Pericarditis, Rash
SMQs:, Anaphylactic reaction (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient has had left sided chest pain that radiates into his left upper back and shoulder x 2 weeks. pt states that he is sob and his sob is worse when he lays down. pt states that his cp and sob improves when leaning forward. pt states that he initially got a rash, then developed the cp, sob after getting his 2nd pfizer covid vaccine on 9/4. No fever, n/v/d, cough, or edema. Patient presenting with clinical pericarditis, with possible sub-acute peri-myocarditis. Prescribed losartan, ibuprofen, Pepcid, and colchicine and instructed to follow up with primary care provider in 1 week, or to return to ER if symptoms worsen.


VAERS ID: 1719586 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Georgia  
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 FC3183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Injection site pain, Nausea, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 25mcg, multi-vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillins, Ceclore, Erythromycin, Sulfur, Azithromycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache lasting 24 hours, nausea and vomiting lasting 6 hours, trembling lasting 4 hours, dizziness lasting 6 hours, injection site soreness lasting 3 days


VAERS ID: 1719645 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
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 FC3181 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Fatigue
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: N/A
Preexisting Conditions: amenorrhea, ASC-H, dizziness, HPV, moderate major depression, PTSD, prediabetes
Allergies: NKDA
Diagnostic Lab Data: Normal neuro exam, no focal deficits or weaknesses. No palpitations, chest pain, SOB, or anxiety. Normal orthostatics. Endorses mild fatigue. Negative Dix-Hallpike. Given meclizine to help with symptoms.
CDC Split Type:

Write-up: A few days after her second dose of COVID-19 vaccination, patient reported onset of dizziness. Has had dizziness before, however now having dizziness daily, at higher intensity level than she has had in the past.


VAERS ID: 1719824 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-03
Onset:2021-09-04
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001A21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Fatigue, Infusion, Oropharyngeal pain, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Outpatient Medications busPIRone (BUSPAR) 15 MG tablet Dexmethylphenidate HCl 25 MG CAP SR24 eletriptan (RELPAX) 20 MG tablet HYDROcodone-acetaminophen (NORCO) 5-325 MG per tablet ibuprofen (MOTRIN) 400 MG tablet meloxicam (MOBIC) 15 MG tab
Current Illness: No
Preexisting Conditions: Cardiovascular and Mediastinum Migraine Respiratory Atopic rhinitis Digestive GERD (gastroesophageal reflux disease) Musculoskeletal and Integument Plantar fasciitis Chondromalacia of left knee Posterior tibial tendinitis of right lower extremity Anxiety and Depression Depression with anxiety Other Vitamin D deficiency Morbid obesity with body mass index (BMI) of 45.0 to 49.9 in adult (CMS/HCC)
Allergies: No Known allergies
Diagnostic Lab Data: 9/8/21-rec''d Regeneron infusion
CDC Split Type:

Write-up: 9/4/2021-Symptoms include fatigue, post nasal drip, non-productive cough and sore throat. Denies fever, chills, anosmia, dysgeusia and headache. Sick contacts: works in school system, frequent sick contacts SARS-CoV-2 immunity status: fully vaccinated Patient reports history of: seasonal or environmental allergies Patient has taken cough suppressants and antihistamines with partial effect Sig: Take 400 mg by mouth every 6 (six) hours as needed for Pain


VAERS ID: 1721553 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-05
Onset:2021-09-04
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling abnormal, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular 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? 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: feeling miserable; aches; nausea; dizziness; chills; fever; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (feeling miserable), MYALGIA (aches), NAUSEA (nausea), DIZZINESS (dizziness) and CHILLS (chills) in an 87-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A and 939893) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 05-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 CHILLS (chills) and PYREXIA (fever). On an unknown date, the patient experienced FEELING ABNORMAL (feeling miserable), MYALGIA (aches), NAUSEA (nausea) and DIZZINESS (dizziness). At the time of the report, FEELING ABNORMAL (feeling miserable), MYALGIA (aches), NAUSEA (nausea), DIZZINESS (dizziness), CHILLS (chills) and PYREXIA (fever) outcome was unknown. Not Provided No concomitant medications was reported. No treatment information was provided. This case was linked to MOD-2021-313344 (Patient Link).


VAERS ID: 1721578 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Fatigue, Injection site pain, Musculoskeletal stiffness, Myalgia, Neck pain, Neuralgia, Oral herpes, Pain, Toothache
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Opportunistic infections (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: Melatonin, 5HTP for sleep the night after vaccination. Multivitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Seasonal allergies. Food and other allergies unkown.
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9/4/21 Injection site painful all throughout arm. Had stomach pain, Nerve pain in some fingers. Left side pain and very Tired. 9/5/21 Woke up with severe muscular pain in my left shoulder going up the left side of my neck. This continued for 2 days and developed into a stiff neck on 9/7/21. The neck stiffness continued for over a week. 9/14/21 I experienced nerve pain in a tooth in my upper left jaw. 9/20/21 My upper lip broke out in a fever blister.


VAERS ID: 1721623 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-26
Onset:2021-09-04
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0251202A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Off label use, Palpitations, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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? 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: not an immunocompromised patient; Hives; Stomach feels like burning and upset; Heart pumping occasionally; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Hives), ABDOMINAL DISCOMFORT (Stomach feels like burning and upset), PALPITATIONS (Heart pumping occasionally) and OFF LABEL USE (not an immunocompromised patient) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040C21A, 029L20A and 0251202A) for COVID-19 vaccination. No Medical History information was reported. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Implant) 1 dosage form. On 23-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 21-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced URTICARIA (Hives), ABDOMINAL DISCOMFORT (Stomach feels like burning and upset) and PALPITATIONS (Heart pumping occasionally). On an unknown date, the patient experienced OFF LABEL USE (not an immunocompromised patient). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL ITCH) ongoing since an unknown date for Adverse event, at a dose of Every 6 hours. At the time of the report, URTICARIA (Hives), ABDOMINAL DISCOMFORT (Stomach feels like burning and upset) and PALPITATIONS (Heart pumping occasionally) outcome was unknown and OFF LABEL USE (not an immunocompromised patient) had resolved. Unknown No Concomitant Medications were provided by the reporter


VAERS ID: 1721723 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Off label use
SMQs:

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

Write-up: Off label use; This spontaneous case was reported by a consumer and describes the occurrence of OFF LABEL USE (Off label use) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high. On 04-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 OFF LABEL USE (Off label use). At the time of the report, OFF LABEL USE (Off label use) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication use was reported. This case was linked to MOD-2021-318424 (Patient Link).


VAERS ID: 1721758 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Palpitations, Pyrexia, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Injection arm was aching; Fever; Chest pain; Heart started racing; Fluttering in her chest; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (Heart started racing), CHEST DISCOMFORT (Fluttering in her chest), VACCINATION SITE PAIN (Injection arm was aching), CHEST PAIN (Chest pain) and PYREXIA (Fever) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. 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 (Heart started racing), CHEST DISCOMFORT (Fluttering in her chest) and CHEST PAIN (Chest pain). On 05-Sep-2021, the patient experienced VACCINATION SITE PAIN (Injection arm was aching) and PYREXIA (Fever). The patient was treated with IBUPROFEN (MOTRIN [IBUPROFEN]) for Adverse event, at an unspecified dose and frequency. At the time of the report, PALPITATIONS (Heart started racing), CHEST DISCOMFORT (Fluttering in her chest), VACCINATION SITE PAIN (Injection arm was aching), CHEST PAIN (Chest pain) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication details were not reported by the reporter. Treatment details was not reported by the reporter. Patient stated that she received her 1st dose of the Moderna COVID 19 vaccine on 4SEPT2021 at Rite Aid. 30 minutes after getting the vaccine, her heart started racing, she felt some fluttering in her chest, and she had a chest pain. The symptoms lasted for 2 minutes; she did not get an EKG done. The next day, she had fever, her injection arm was aching, and she had chest pain which was on and off through out the day; it was not persistent that she needed to call 911. She went to her doctor today; her doctor said the vaccine is safe, but she feels her doctor is bias. She took Motrin at the time she was having the symptoms. She was not having the symptoms at the time of the call. She gave a consent for safety to follow-up with her or her healthcare provider. Lot number and date of birth was provided by patient but the information was deleted when system crashed.


VAERS ID: 1721909 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Dizziness, Heart rate, Heart rate irregular, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210904; Test Name: Blood pressure; Result Unstructured Data: Test Result:little elevated; Test Date: 20210904; Test Name: Heart rate; Result Unstructured Data: Test Result:123; Comments: resting heart rate 123
CDC Split Type: USPFIZER INC202101169505

Write-up: having elevated heart rate; dizzy/Lightheaded; blood pressure being elevated/blood pressure a little elevated; Episodes of spike in heart rate; This is a spontaneous report from a contactable consumer (patient). A female consumer of unknown age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 03Sep2021 at single dose for COVID-19 immunisation. Medical history and concomitant medications were unknown. The patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on unknown date for covid-19 immunisation. On 04Sep2021, the day after the vaccine, the patient started having elevated heart rate, resting 123 beat per minute (BPM); since then, the patient was having episodes elevated heart rate, blood pressure being elevated and dizzy. The patient had been trying to get in and of course no one was taking walk-ins, most appointments were booked. Pharmacist indicated because they are more like episodes rather than it being elevated consistently and uncontrollable, not thinking medical emergency. In 04Sep2021, blood pressure was little elevated, and heart rate was 123 (resting heart rate). The outcome of the events was unknown. Follow-up attempts are completed. The batch/lot number is not available despite the follow-up attempts made. No further information is expected.


VAERS ID: 1722049 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-01
Onset:2021-09-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Computerised tomogram, Computerised tomogram normal, Cough, Dysarthria, Dysphagia, Feeling abnormal, Magnetic resonance imaging abnormal, Scan with contrast abnormal, Thinking abnormal, Transient ischaemic attack
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: SYNCOPE AND COLLAPSE MALIGNANT NEOPLASM OF RECTUM HYPOKALEMIA PAROXYSMAL ATRIAL FIBRILLATION EMPHYSEMA (SUBCUTANEOUS) RESULTING FROM A PROCEDURE, SUBSEQUENT ENCOUNTER
Allergies: None noted
Diagnostic Lab Data: CT and MR Send to ER for evaluation rule out possible CVA. 9/4/2021 CAT scan was negative, patient will be getting MRI with contrast. noted in progress notes on 9/4 9/10/2021 noted patient was diagnosed with G45.9: TRANSIENT CEREBRAL ISCHEMIC ATTACK, UNSPECIFIED per MRI 47.1: DYSARTHRIA AND ANARTHRIA, although the patient is discharged..
CDC Split Type:

Write-up: Patient sitting on side of the bed. The patient had slurred speech and was unable to form his thoughts. The patient was last seen by a nurse''s aide and was speaking clearly. Patient alert. Attempted to take one pill and had difficulty swallowing and began coughing. No other medications were given. Assisted patient to lying position. The patient is able to move all extremities. The patient was able to state he just didn''t feel right.


VAERS ID: 1722479 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-19
Onset:2021-09-04
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / IM

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

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

Write-up: ARM SWELLING, ITCHING AND RASH


VAERS ID: 1722582 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Neutrophil count decreased, Pyrexia
SMQs:, Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Diltiazem XR, Metoprolol, Allopurinol, Lorazapam
Current Illness:
Preexisting Conditions: Gout, High Blood Pressure
Allergies:
Diagnostic Lab Data: Blood Panel done on 9/8/2021 showed that i had low neutrophils count
CDC Split Type:

Write-up: Fever, Chills, Fatigue, severe Joint pain


VAERS ID: 1723152 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Musculoskeletal stiffness
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Sexual dysfunction (broad)

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

Write-up: At 3:30pm shortly after my first shot, the left side of my neck was very stiff and numb at lunch. Around 6pm my left bottom lip felt numb and part of my left side of face. The feeling was like when you have had Novocain for dental work but only about half numb. Felt mostly better by morning the next day however I feel like the complete feeling hasn''t returned mostly around my left cheek to chin.


VAERS ID: 1723326 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acrochordon, Dizziness, Feeling abnormal, Feeling jittery, Headache, Palpitations, Pruritus
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Cardiomyopathy (broad), Vestibular 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? 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: Headache, head fog, feeling jittery, itching (subsided), skin tag, heart throbbing and lightheadedness.


VAERS ID: 1723570 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Catheterisation cardiac, Chest discomfort, Chest pain, Dyspnoea, Echocardiogram, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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:
Current Illness: No
Preexisting Conditions: Heart stents Dysautonomia
Allergies: None
Diagnostic Lab Data: Heart Cath Echo Bloodwork
CDC Split Type:

Write-up: Shortness of breath, chest pain, all over fatigue, pressure in chest.


VAERS ID: 1723606 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Headache, Paraesthesia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ASTHMA
Allergies: NONE
Diagnostic Lab Data: called DR. NO ONE CARED SAID IT WILL PASS !!!! No one cares still about effects...I call they say give it time..
CDC Split Type:

Write-up: Pins And needles feeling all over body (still have), 104.3 fever & chills for 3 days feel dizzy and headache(still have) heart . worst part of all is hard to breath still walking upstairs getting winded ... trying to catch my breath since shot...


VAERS ID: 1723873 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-09-04
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Hypertension, Nausea, Productive cough, Pyrexia, SARS-CoV-2 test positive, Sputum discoloured
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: she developed cough shortness of breath and tested positive for COVID19 approximately 1 week ago. She was unable to give me to the exact day her symptoms started or she tested positive. Since then she has had fevers, chills, nausea, and has now developed a cough productive of thick yellow sputum. She is on 2 L nasal cannula baseline and today was noted to require up to 4 L nasal cannula for proper saturations prompting evaluation in the emergency department. On arrival to the ED she is hypertensive into the 160s with a normal heart rate. She was satting in the mid 90s on 4 L nasal cannula.


VAERS ID: 1723874 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamoxifen, Calcium with vitamin D, multi vitamin
Current Illness: none
Preexisting Conditions: Breast cancer
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Red bumpy rash with slight itch in the beginning. Rash went from just under the left breast down to hip and from the midline of front torso and wrapped around to back. Lasted 7 days decreasing in itch and redness as time progressed.


VAERS ID: 1726326 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-31
Onset:2021-09-04
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthma, COVID-19, Condition aggravated, Hyperglycaemia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Combivent respimat inhaler, atorvastatin, gabapentin, insulin glargine, lactulose, lisinopril, lithium, metformin, pantoprazole, ropinirole, trazodone.
Current Illness:
Preexisting Conditions: anemia, anxiety, arthritis, asthma, bipolar 1, carpal tunnel syndrome, chronic back pain, chronic sinusitis, COPD, DM, diverticulitis, fibromyalgia, GERD, hyperlipidemia, hypertension, hypotension, IBS, insomnia, HX kidney stones, migraine headache, OUD, OSA, Osteoarthritis, PUD, post laminectomy syndrome, restless leg syndrome
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was fully vaccinated with the Moderna COVID-19 vaccine, on 3/1/2021 and 3/31/2021 respectively. On 9/4/2021, pt tested positive for COVID-19. Pt subsequently hospitalized for COVID-19 infection which resulted in asthma exacerbation and steroid induced hyperglycemia. Admitted 9/16/2021, discharged 9/18/2021.


VAERS ID: 1726402 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-19
Onset:2021-09-04
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Feeling abnormal, Malaise, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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? No
Previous Vaccinations:
Other Medications: Nexium
Current Illness:
Preexisting Conditions: Acid reflux
Allergies:
Diagnostic Lab Data: COVID- 19 test positive.
CDC Split Type: vsafe

Write-up: The week prior, I work in an office of 20 people and I was #12 of being positive for COVID. I woke up, felt funny, had a cough and I went and tested and I was positive for COVID. Saturday through Monday I just did not feel well, then Tuesday I had a fever, chills, body aches and by Monday the following week I still had a fever and cough by Wednesday I felt better.


VAERS ID: 1726480 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-26
Onset:2021-09-04
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to the hospital for COVID-19 symptoms and was treated with typical COVID medications. Patient discharged to home


VAERS ID: 1726486 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-09-04
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to the hospital with COVID symptoms and was treated with typical COVID medications. Patient was discharged home with hospice.


VAERS ID: 1726507 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-31
Onset:2021-09-04
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic lung disease, other unknown conditions and risk factors
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and hospitalized due to Covid related symptoms. She developed symptoms on 09/04/2021 and is still symptomatic. major symptom was shortness of breath. She was admitted to the hospital on 09/04/2021 and released on 09/05/2021 when her oxygen levels improved.


VAERS ID: 1726741 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 200mcg, Since 9.4.21 also taking metoprolol and vitamin C
Current Illness: None
Preexisting Conditions: Grave''s Disease and Hashimoto''s
Allergies: None
Diagnostic Lab Data: EKG: 9.5.21. Eco scheduled for 10.1.21
CDC Split Type:

Write-up: 1.5 days after receiving vaccine patient started having palpitations consistently for 2 days. Patient went to PCP 3 days after receiving vaccine - abnormal EKG at that time. Placed on metoprolol and echo scheduled for 10.1.21 and cardiology appoint,ent scheduled for one week after.


VAERS ID: 1726871 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chills, Decreased appetite, Diplopia, Ear discomfort, Electrocardiogram, Fatigue, Full blood count, Incontinence, Lipase, Loss of consciousness, Malaise, Metabolic function test, Pyrexia, Syncope, Troponin I, Urine analysis, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Ocular motility disorders (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Influenza vaccine. Unknown date/brand/age. Patient reported hx of diarrhea, vomiting, muscle aches and fever following vaccine.
Other Medications: Alendronate, Aller-tec, Hydroxyzine, Metoprolol, Omeprazole, Raloxifene, Simvastatin
Current Illness: Had brief episode of weakness, runny nose, cough, nausea, diarrhea, and muscle aches after her 1st dose of Moderna covid vaccine 3 weeks prior. Symptoms resolved prior to 2nd vaccine on 9/2/21
Preexisting Conditions: hyperlipidemia, insomnia, osteoporosis, hypertension, GERD.
Allergies: Benzonatate (rash), Heparin (rash) , Influenza vaccine (diarrhea, vomiting, myalgia, fever), Macrobid (diarrhea, vomiting), Sulfa (rash)
Diagnostic Lab Data: Hospital ER 9/4/2021- EKG, CXR, UA, CBC, BMP, Troponin I, Hepatic function panel, Lipase.
CDC Split Type:

Write-up: Pt had syncopal episode on 9/4/21. Got up early in AM to use restroom and get drink. Passed out at the kitchen sink. Spent about 3.5 hours on the ground. She believes she was in and out of conciousness at that time. Was found laying in emesis, stool, urine. Had diarrhea x3 throughout the night. Was feeling ill starting the night before with chills, subjective fever, fatigue. Had her first diarrhea episode that night. These symptoms started 1.5 days after her 2nd covid vaccine (Moderna). She was taken by EMS to the ER. Workup in ER included labs, CXR and EKG. She was treated with fluids and zofran and discharged to home. She had double vision until yesterday. This primarily occured with turning head quickly. Takes some time before eyes focus. Clicking/pressure in ears, poor appetite. Overall she feels that she has improved. No headache, N/V, diarrhea, N/V.


VAERS ID: 1726953 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-09-04
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SERTRALINE, ATORVASTATIN, OMEPRAZOLE, CLARITIN, VIT B
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID TEST ON 9/4/21 FEVER ANTIBODY THERAPY


VAERS ID: 1727021 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-03
Onset:2021-09-04
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER 8734 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Coagulopathy
SMQs:, Haemorrhage laboratory terms (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: Sept 2021
CDC Split Type:

Write-up: Blood clotting issues


VAERS ID: 1728726 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01TEZIA / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Hypoaesthesia, Inflammation, Muscular weakness, Neck pain, Pain, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin d3
Current Illness: no
Preexisting Conditions: Arthritis
Allergies: Succinyl Choline
Diagnostic Lab Data: None
CDC Split Type: 017EZIA

Write-up: I was in extreme Pain. Everywhere I have ever had an injury previously was in horrid pain for at least 4 days then it has changed to chronic. My scar tissue on my head was and still is inflamed. I have numbness from my knees to my ankles and my ankles are weak. my joints and my neck are soar, I am very tired and can hardly do a good job at work because of it. I have minor heart palpitations,.


VAERS ID: 1730421 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Decreased appetite, Dizziness, Dyspnoea, Fatigue, Feeling of body temperature change, Oxygen saturation, Stress
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN C [ASCORBIC ACID]; VITAMIN D NOS; PRENATAL VITAMINS [ASCORBIC ACID;BETACAROTENE;CALCIUM SULFATE;COLECALCIFEROL;CYANOCOBALAMIN;FERROUS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Miscarriage
Allergies:
Diagnostic Lab Data: Test Name: Temperature; Result Unstructured Data: Test Result:100; Test Name: Oxygen Saturation; Test Result: 98 %
CDC Split Type: USPFIZER INC202101182531

Write-up: stressed; not eating or drinking like she should; Almost a dizzy and faint feeling; temperature was at 100; shortness of breath; hot and clammy; tiredness/ fatigue; This is a spontaneous report from a contactable nurse (patient). A 30-year-old female patient received BNT162B2, via an unspecified route of administration, administered in right deltoid muscle on 04Sep2021 13:30 (Batch/Lot Number: FC3182; Expiration Date: 31Oct2021; NDC: 59267-1000-03) at the age of 30 years old as dose 2, 0.3 ml single for COVID-19 immunization. Medical history included Anxiety. She has history of it. It got worse this past year because she has had two miscarriages this past year and it exacerbated the anxiety. That was her reason for getting the vaccine, she wanted to try again to get pregnant later on. No family medical history relevant to adverse events. There is no asthma or diabetes. There is anxiety and depression in the family. Concomitant medication(s) included vitamin c [ascorbic acid]; vitamin d nos; ascorbic acid, betacarotene, calcium sulfate, colecalciferol, cyanocobalamin, ferrous fumarate, folic acid, nicotinamide, pyridoxine hydrochloride, retinol acetate, riboflavin, thiamine mononitrate, tocopheryl acetate, zinc oxide (PRENATAL VITAMINS) taken for unspecified indications, start and stop dates were not reported. Clarified that she is not pregnant. Prior Vaccinations included Tetanus booster in Nov2020 (the last thing she had). No adverse events following prior vaccinations (So far so good with every vaccine she has had). The patient previous received first dose of BNT162B2 (Batch/Lot Number: FA6780; Expiration Date: 30Sep2021; NDC: 59267-1000-03), 0.3ml injected in left deltoid on 07Aug2021. Someone told her if she switched arms the side effects aren''t as bad, she thinks they lied. Received Pfizer COVID Vaccine because part of it was wanting to get pregnant, but the main reason was being school nurse and wanting to protect herself. Patient wanted to double check about possible side effects to the Pfizer vaccine. She went on 04Sep2021 at 1:30 PM (Saturday) and got second dose of Pfizer COVID vaccine. She experienced shortness of breath, hot and clammy (hot and clamminess) on 07Sep2021 (Tuesday) after receiving the vaccine. She was fine over the weekend. She experienced tiredness and fatigue and went back to work on Tuesday. Her temperature was at 100 (also reported as degree C). Was asking if others have reported a similar reaction to the vaccine and wanted to know how long she would expect for her side effects to be back to normal. The patient had been feeling ok, but the weekend was better when she could sleep and relax. She has been tired and fatigued. Being back at work on Tuesday, Wednesday, and Thursday she has been short of breath. More short of breath than usual. She is a school nurse and has to wear a mask. She is not sure if it was stress. She has checked her oxygen saturation and it is 98%. She was more tired than usual on Saturday and Sunday, started about 6PM on 04Sep2021. It was not serious, but noticeable. She doesn''t have to go to ER. Short of breath started on 07Sep2021 (Tuesday), when she was back to at work when she was running around. She noticed she couldn''t catch her breath like normal. As a nurse, she panicked and worried about blood clots. It was ongoing and persisting. It was noticeable with exertion. She was worried. Reporter seriousness for short of breath was medically significant. She would be at hospital if disabling. Reporter seriousness for hot and clammy was not serious. Hot and clammy also started on 07Sep2021 (Tuesday). Her temp was sitting around 100. That is a mixture of dehydration and wearing a mask at work. Her temperature has been around 100 at work and the hot and clammy feeling set in. It was ongoing especially with exertion. She feels it when at work and running around. Almost a dizzy and faint feeling hit her today (also reported as on 09Sep2021) and it worried her. Being so stressed she was not eating or drinking like she should, and she knows that was part of it. Work stress is not helping. She came home early from work because she was not feeling well. Events did not require a visit to Emergency Room nor Physician Office. She wanted to avoid that at all cost with how bad COVID is. Outcome of events shortness of breath, hot and clammy and fatigue was not recovered; while other events was unknown. Event relatedness of Pfizer COVID Vaccine with tired and fatigued, hot and clammy - Related. Causality: Tired and fatigued, Short of breath, Hot and clammy: Yes, because it has happened since she got it. She has a lot of stress and anxiety going on too, but it was exacerbated after the vaccine. Relatedness of drug to reaction(s)/event(s): tired and fatigued, Short of breath, hot and clammy (Source of assessment: Primary Source Reporter, Method of assessment: Global Introspection) - Drug result: Related.; Sender''s Comments: Based on the information currently available, a possible contributory role of the suspect vaccine BNT162B2 or comirnarty in triggering the onset of shortness of breath cannot be excluded.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: 1731233 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 3 LA / IM

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

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

Write-up: Following discharge, after 15 min monitoring, pt. c/o dizziness. B/P was taken 124/64, monitored further until 12:40 PM. No further issues.


VAERS ID: 1731493 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)

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

Write-up: Ever since my first dose of my vaccination my left hand is stiff in the early morning hours, I wake up about 4 AM It takes a while for my hand to be able to move comfortably.


VAERS ID: 1731922 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abscess, Cellulitis, Chills, Extra dose administered, Hypersomnia, Product preparation issue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: sulfa
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient received 3rd dose of Pfizer Covid on 9/3/21 about 4:30pm. Patient stated she went home and on 9/4 pretty much slept all day. On 9/5 she went to urgent care for fever and chills, she received antibiotic and was told she has cellulitis and abscess due to improper vaccination technique causing bacterial infection. She followed up with dermatologist 1 week later where she got cortisone cream and was told it was most likely due to improper technique. patient stated on 9/22 she has another follow up with dermatologist in 1 week.


VAERS ID: 1732024 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Burning sensation, Diarrhoea, Dysmenorrhoea, Frequent bowel movements, Gait disturbance, Headache, Heavy menstrual bleeding, Hyperhidrosis, Induration, Lymphadenopathy, Menstruation irregular, Pyrexia, Vaginal haemorrhage, Weight decreased
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad), Arthritis (broad), Noninfectious diarrhoea (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: Flu shot makes me feel tired.
Other Medications: Prenatal vitamins; LINZESS; Last date i took it was September 3, 2021 because every since September 4, 2021; Amitriptyline
Current Illness: No
Preexisting Conditions: IBSC; PCOS; Chronic neck and back pain from a motor vehicle wreck; Chronic migraines
Allergies: Penicillin gives me a rash; Benzonatate; Lactose intolerant
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Woke up that morning drenched in sweat. I was literally burning from the inside out every joint was hurting. I had a low grade temp as high as 102 as low as 99. On September 4, 2021 and September 5, 2021. My left arm pit was hard as a rock sore to touch couldn''t walk. Temp was 101.9. From September 4, 2021 to Labor day weekend it stopped. I was alternating my migraine meds and my neck and back pain medication just to sleep at night. Within 3 hours Diarrhea started, 3 bowel movements a day since the shot by the end of the day it was loose stool. After second shot I couldn''t see a doctor bc I was a new patient. I have been loosing a significant amount of weight since the shot because of so many bowel movements. Spotting, painful, heavy. irregular periods Ongoing headaches, 2 swollen lympnodes under left arm pit.


VAERS ID: 1732026 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Blindness, Pain in extremity, Paraesthesia, Visual impairment, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Customer was at the pharmacy getting their COVID-19 vaccine and had gotten their shot and they were waiting for the recommended 15 minutes after the shot sitting by the blood pressure machine in front of the pharmacy. While the customer was waiting after about 5 minutes her arm/hand started to hurt/tingle quite a bit, then her vision began to get "spotty" which she described as "black spots" then she lost her vision completely and went completely black, but she seemed to still be conscious and had not passed out, and could not see at all for about 2 minutes. Then began to have a upset stomach and threw up. After she threw up she said her vision began to come back until it was back to normal. During this time her boyfriend had called her mother who showed up right as EMS was leaving.


VAERS ID: 1732082 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral normal, Aphasia, Arteriogram carotid normal, Conversion disorder, Dysarthria, Echocardiogram, Facial paralysis, Gait disturbance, Headache, Hemianaesthesia, Hemiparesis, Laboratory test, Magnetic resonance imaging head normal, Migraine, Neurological examination abnormal, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen 325 MG tablet; albuterol 90 mcg/actuation inhaler Inhale 2 puffs into the lungs every 6 (six) hours as needed for Wheezing; Bismuth subsalicylate 262 mg/15 mL suspension; clindamycin 1 % lotion Apply topically 2 (two) times d
Current Illness:
Preexisting Conditions: breast cancer s/p curative intent chemo and radiation (completed 4/2021), RA on Plaquenil, HTN, PE (2020), ILD (awaiting outpatient pulmonology referral), GERD, ex smoker
Allergies: Benadryl, aspirin, PCN, gabapentin
Diagnostic Lab Data: CTA head and neck. Brain MRI. Echo. Labs.
CDC Split Type:

Write-up: The patient received her third Pfizer vaccination into her left deltoid at 9 AM on the day of admission. At 1 PM on the day of admission she was at work at when she developed left-sided weakness, facial droop, left-sided numbness, left-sided headache, blurry vision, gait instability, slurred speech, word searching. In the ED she was initially evaluated as a code stroke. The CT scanner was down at the time so she proceeded to a brain MRI/A brain. This was negative. She was admitted to the hospitalist service for ongoing evaluation. Neuro exam of the time of admission was inconsistent. Differential included conversion disorder versus migraine. She was eventually able to receive a CTA of the head neck which was negative. Echo is still pending at the time of discharge, although anticipate this will be unremarkable. On the day of discharge the patient has a residual headache but all of her other neurologic deficits have resolved. Ultimately, her symptomatology may be psychosomatic, although it may represent a hyper immune response given the third Covid vaccine dose she received 5 months after her second dose. She will discharge home with no new medications or changes.


VAERS ID: 1732225 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-09-04
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of personal independence in daily activities, Pruritus, Urticaria, Urticaria chronic
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B12, VitaminD3, Vitamin C
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs (bactrim) and benzoyl peroxide
Diagnostic Lab Data: None, the doctor just looked at it and prescribed steroids.
CDC Split Type:

Write-up: I?ve developed chronic urticaria, it?s lasted since September 4th and it comes and goes all over my body in the form of itchy lacy hives. Initially it was treated by my doctor with a steroid shot, that didn?t work. Then I was given 6 days of prednisone and steroid cream by the walk in clinic. That didn?t work. They are all over my body and it?s making daily life very tough with the terrible itching. It will show up in one place, then disappear and show up somewhere else. Everywhere from my face, arms, neck, back, legs, hands, etc it?s miserable.


VAERS ID: 1733564 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ataxia, C-reactive protein normal, Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram spine, Drug screen negative, Full blood count normal, Metabolic function test normal, Muscular weakness, Pyrexia, Syncope, Troponin normal, Urine analysis normal
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: HTN
Allergies: azithromycin
Diagnostic Lab Data: 9/4/21 CT head, CT c-spine, CXR, trop, crp, cbc, cmp, drug screen, u/a no significant findings
CDC Split Type:

Write-up: fever, syncopoe, ataxia with ambulation and LE weakness


VAERS ID: 1733912 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / UNK LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Fatigue, Peripheral swelling, Pruritus, Skin mass, Sluggishness, Vaccination site warmth
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Feeling a little more sluggish and tired than usual; Feeling a little more sluggish and tired than usual; Started itching; Fever came back in the area; Redness; knot- it feels thick; And spreading and covers 4top to bottom x 6inches front to back of the upper arm; Red; Knot- thickness; The area was feverish; Spread out to a size of 2 top to bottomx4 front to back inches; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Red), SKIN MASS (Knot- thickness), VACCINATION SITE WARMTH (The area was feverish), PERIPHERAL SWELLING (Spread out to a size of 2 top to bottomx4 front to back inches) and PRURITUS (Started itching) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048F21A) 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Sep-2021, the patient experienced ERYTHEMA (Red), SKIN MASS (Knot- thickness), VACCINATION SITE WARMTH (The area was feverish) and PERIPHERAL SWELLING (Spread out to a size of 2 top to bottomx4 front to back inches). On 11-Sep-2021, the patient experienced PRURITUS (Started itching), VACCINATION SITE WARMTH (Fever came back in the area), ERYTHEMA (Redness), SKIN MASS (knot- it feels thick) and PERIPHERAL SWELLING (And spreading and covers 4top to bottom x 6inches front to back of the upper arm). On 16-Sep-2021, the patient experienced SLUGGISHNESS (Feeling a little more sluggish and tired than usual) and FATIGUE (Feeling a little more sluggish and tired than usual). On 09-Sep-2021, ERYTHEMA (Red), SKIN MASS (Knot- thickness), VACCINATION SITE WARMTH (The area was feverish) and PERIPHERAL SWELLING (Spread out to a size of 2 top to bottomx4 front to back inches) had resolved. At the time of the report, PRURITUS (Started itching), VACCINATION SITE WARMTH (Fever came back in the area), ERYTHEMA (Redness), SKIN MASS (knot- it feels thick), PERIPHERAL SWELLING (And spreading and covers 4top to bottom x 6inches front to back of the upper arm), SLUGGISHNESS (Feeling a little more sluggish and tired than usual) and FATIGUE (Feeling a little more sluggish and tired than usual) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient usually has reactions to flu shots, bee stings. No Concomitant medication were reported. No treatment medication were reported.


VAERS ID: 1734065 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-15
Onset:2021-09-04
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hot flush, Migraine, Myalgia, Rash erythematous
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: hot flash; migraine; red rash; aches around body; This spontaneous case was reported by a consumer and describes the occurrence of HOT FLUSH (hot flash), MIGRAINE (migraine), RASH ERYTHEMATOUS (red rash) and MYALGIA (aches around body) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A, 011M20A and 002B21A) for COVID-19 vaccination. Concomitant products included ALPRAZOLAM (XANAX), ALBUTEROL [SALBUTAMOL], DULOXETINE HYDROCHLORIDE (DULOXETINE HCL) and TRAZODONE for an unknown indication. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-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 HOT FLUSH (hot flash), MIGRAINE (migraine), RASH ERYTHEMATOUS (red rash) and MYALGIA (aches around body). At the time of the report, HOT FLUSH (hot flash), MIGRAINE (migraine), RASH ERYTHEMATOUS (red rash) and MYALGIA (aches around body) outcome was unknown. No treatment medications provided.


VAERS ID: 1734390 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Oropharyngeal blistering, Pharyngeal inflammation
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: No
Current Illness: No
Preexisting Conditions: No
Allergies: Metronidazole
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Blister in the back of my throat and throat inflammation


VAERS ID: 1734399 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: Pain at Injection Site-Mild, Systemic: menstuation prolong-Mild, Additional Details: pt had covid shot on 09/3/21 1;29pm first shot, next day on 09/4/21, start her period and never stop until 09/24/21, still got second dose on 09/24/21


VAERS ID: 1734699 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Limb discomfort, Muscle twitching, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), 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: Pennicillin & Lovenox
Diagnostic Lab Data:
CDC Split Type:

Write-up: Legs Felt Tingly, numb sleepy, & Heavy. For about a week had random twitching in my legs


VAERS ID: 1735006 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Parent and Patient came to the clinic for a 2nd COVID vaccine Pfizer, when we did not have an appointment for her the patient and mom then went over to the pharmacy to get the 2nd pfizer vaccine. Mom provided the wrong birthday so pharmacist came to the NP at clinic and we looked up the patient and saw the patient was given the pfizer vaccine on 9/4. We asked mom to confirm her birthday and mom reports I lied about her birthday so she could get the vaccine. Both myself (NP) and the pharmacist would not give her the second does due to false information. MOM gave a birthday of (private) and actual Birthday is (private)


VAERS ID: 1736139 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-31
Onset:2021-09-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Facial discomfort, Feeling abnormal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Hearing impairment (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: Valsartan, Tirosint, Rosuvastatin, Vitamin D3, Fish Oil
Current Illness: N/A
Preexisting Conditions: Thyroid Disorder, High Blood pressure all controlled with medication
Allergies: N?A
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Started running low grade fever that Saturday night times 3 days felt bad all week. Following Saturday my face felt strange. Woke up Sunday morning with Bella Palsey. Went to Med Clinic. Diagnosed with Bella Palsey. Given Prednisone, and anti viral. As of today has still not healed .


VAERS ID: 1736140 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-01
Onset:2021-09-04
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Headache, Injection site rash, Pain, Pain in extremity, Pyrexia, Ultrasound scan, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pertussis
Other Medications:
Current Illness: None.
Preexisting Conditions:
Allergies: None.
Diagnostic Lab Data: Neck ultrasound and X-ray for swelling.
CDC Split Type:

Write-up: 1st vaccine: Pain at injection site. Arm pain. Rash 3-4 days after injection on injection site. Swelling near collarbone 8 days after injection. 2nd vaccine: Arm, axillary pain, headache, boy aches, fever, rash at injection site.


VAERS ID: 1737035 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

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

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

Write-up: There was no adverse event noted, but I am reporting because we had a J&J COVID-19 vaccine inadvertently given to a 17 year old (only approved for 18 years and older).


VAERS ID: 1737085 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-09
Onset:2021-09-04
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Laboratory test abnormal, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: no
Allergies:
Diagnostic Lab Data: Rapid test collected 9-7-2021, resulted positive.
CDC Split Type:

Write-up: Runny nose, sore throat, fatigue, congestion.


VAERS ID: 1737357 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-01
Onset:2021-09-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Lymphadenopathy, Ultrasound scan
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: Yes I took prenatal pills.
Current Illness: No other illnesses.
Preexisting Conditions: No chronic or longstanding health conditions.
Allergies: No allergies to anything.
Diagnostic Lab Data: Ultrasound
CDC Split Type: vsafe

Write-up: I felt a lump in my right arm pit. I went to the doctor and got checked and it was swollen lymphoid. Jan19 is my estimated date for delivery.


VAERS ID: 1737392 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-29
Onset:2021-09-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Injection site swelling, Mouth swelling, Oral mucosal blistering, Pharyngeal swelling, Rash pruritic, SARS-CoV-2 test negative
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: CIPD both legs
Allergies: Penicillin
Diagnostic Lab Data: Did have negative covid test results on 9/27/2021
CDC Split Type:

Write-up: 12 inch rash on upper arm centering injection site. Lasting almost 3 weeks. Rash was warm to touch, slightly swollen and itchy. Moderate swelling of roof of mouth, gums and throat with mild blistering on roof of mouth and throat. Lasting almost 3 weeks. No associated fever. Negative covid test results. Did start antibiotics for throat on 9/5/21. This did not resolve swelling or rash/blisters in mouth/ throat. It seemed to clear up significantly by 9/27/2021. Diarrhea days 2-5 after vaccine.


VAERS ID: 1740069 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-01
Onset:2021-09-04
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025021 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immunocompromised
Preexisting Conditions: Medical History/Concurrent Conditions: Lymphoma (Patient was on Chemotherapy for approximately 5 months.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Shingles 3 months after vaccination; This spontaneous case was reported by a physician and describes the occurrence of HERPES ZOSTER (Shingles 3 months after vaccination) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 024L20A and 025021) for COVID-19 vaccination. The patient''s past medical history included Lymphoma (Patient was on Chemotherapy for approximately 5 months.). Concurrent medical conditions included Immunocompromised. In January 2021, the patient received first 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 04-Sep-2021, the patient experienced HERPES ZOSTER (Shingles 3 months after vaccination). At the time of the report, HERPES ZOSTER (Shingles 3 months after vaccination) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. No treatment information was provided.


VAERS ID: 1740149 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Deafness unilateral, Dizziness, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Mitral valve prolapse
Allergies:
Diagnostic Lab Data: Test Date: 20210904; Test Name: BP; Result Unstructured Data: Test Result:Elevated
CDC Split Type: USPFIZER INC202101197686

Write-up: Loss of hearing in Right ear with constant ringing.; Loss of hearing in Right ear with constant ringing.; Dizzinessd and lightheadedness; elevated BP.; This is a spontaneous report from a contactable healthcare professional reporting for herself. A 60-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number FF2588) on 04Sep2021 at 14:00, at the age of 60 years, as the first single dose, in left arm, for COVID-19 immunisation. Medical history included mitral valve prolapse. The patient did not have COVID prior vaccination. Concomitant medications were none (no other vaccines were administered in 4 weeks and no other medications were administered in 2 weeks). On 04Sep2021 at 14:30 the patient experienced loss of hearing in right ear with constant ringing, dizziness and lightheadedness with elevated BP. The events resulted in Doctor or other healthcare professional office/clinic visit and required treatment (flushed ear and told to go to ENT/take Advil). COVID was not tested post vaccination. The events had not yet resolved.; Sender''s Comments: Based on the current available information and the plausible drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of event Deafness unilateral cannot be totally excluded.The impact of this report 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: 1741103 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Computerised tomogram neck, Condition aggravated, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Chemo-Keytruda, carboplatin, Pacitaxel Hydroxyzine Zofran Albuterol Sulfate ASA Spironolactone Prochlorparazine Maleate Betamethasone Dipropinate Lactobacillus Vit D Amitripline ACL Finasteride Lyrica omeprazole Vit C Actos Terozosin Cre
Current Illness: Squamous cell carcinoma head/neck
Preexisting Conditions: DM OSA
Allergies: Metformin Quinine
Diagnostic Lab Data: CT scan at hospital on 9/14/21 Pt also states cancer treatment is going to change
CDC Split Type:

Write-up: Pt has know squamous cell carcinoma in neck area, one day after vaccine he felt increased swelling in neck area, this continued to worsen every day following, he was seen by oncology and a stat CT scan was ordered of soft neck tissue, which revealed a significant increase in size of cancer compared to previous scan done on 7/23/2021


VAERS ID: 1741640 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Polymenorrhoea
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: DTP as child caused moderate adverse reaction, details unknown
Other Medications:
Current Illness:
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menses began 1 week early than normal and was accompanied by significantly more painful cramping than usual. Increased pain and more frequent cramping was present during next pre-menstruatal and menses time. Prior to receiving second vaccine.


VAERS ID: 1741760 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-09-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Mechanical urticaria, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 24 hours after receiving the vaccine I had chills and diarrhea which seemed standard. However, a week after the injection, the diarrhea came back for 48 hours and I broke out in full body hives. Since the initial breakout, I have hives that come and go which I treat with an OTC anti-histamine and I have dermatographia.


VAERS ID: 1744369 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-13
Onset:2021-09-04
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Headache, 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: Rapid test positive on 9-10-2021
CDC Split Type:

Write-up: headache


VAERS ID: 1744372 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-13
Onset:2021-09-04
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Myalgia, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Rapid test positive on 9-10-2021
CDC Split Type:

Write-up: Fever, muscle ache, cough, headache, congestion


VAERS ID: 1744389 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-31
Onset:2021-09-04
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Diarrhoea, Headache, Myalgia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Rapid test positive on 9-13-2021
CDC Split Type:

Write-up: Muscle Ache, cough, headache, diarrhea, loss of taste and smell, congestion


VAERS ID: 1744521 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-27
Onset:2021-09-04
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: SARS-CoV-2 test
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Rapid at home test done and reported on 9-4-2021
CDC Split Type:

Write-up: unknown


VAERS ID: 1744684 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-01
Onset:2021-09-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy
SMQs:, 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: Optimum Nutrition Opti-Men Multivitamin Dr. Tobias Omega-3 Fish Oil
Current Illness:
Preexisting Conditions: Herniated disc L5-S1
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving Dose #1 of Pfizer vaccine in left shoulder, severe swelling of lymph nodes in left neck, left collarbone and left armpit occurred for about a week before subsiding. Lymph nodes were very tender to the touch with the collarbone area protruding enough to be noticed without touch. After around 1 week after discovery, lymph nodes reduced in swelling.


VAERS ID: 1745073 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Urticaria chronic
SMQs:, Angioedema (narrow), Hypersensitivity (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: Vyvanse, Wellbutrin, women?s multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Chronic uticaria


VAERS ID: 1745559 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood lactate dehydrogenase, Blood thyroid stimulating hormone, C-reactive protein, Condition aggravated, Differential white blood cell count, Eczema, Fatigue, Full blood count, Haematocrit, Haemoglobin, Hypersomnia, Lipids, Metabolic function test, Platelet count, Product administered to patient of inappropriate age, Red blood cell count, Red blood cell sedimentation rate, Thyroxine free, White blood cell count
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), 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: LEVETIRACETAM 100 MG/ML
Current Illness: NONE
Preexisting Conditions: HISTORY OF ASTHMA, ECZEMA, SEIZURE DISORDER
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: LABORATORY TESTING ORDERED ON 09/28/2021 AND RESULTS STILL PENDING Complete (CBC), automated (Hgb, Hct, RBC, WBC, and platelet count) and automated differential WBC count (Send-Out) Free T4 (Send-Out) Thyroid stimulating hormone (TSH) (Send-Out) ESR (Send-Out) C-reative protein; high sensitivity (hsCRP) (Send-Out) Comprehensive metabolic panel (Send-Out) Lipid panel (Send-Out) LDH
CDC Split Type:

Write-up: PATIENT UNDER THE AGE OF 12 YEARS CURRENT AGE 6 YEAR OLD. On 9/25/21 patient came into office for second COVID-19 Pfizer vaccine, was given 1st vaccine on 9/4/2021, that should not have been given. Second dose was not given & this was explained to the mother. Dr. discussed this with mother on 9/27/2021.Fatigue started 4 days after vaccine. Going to sleep early during the week. Napping during the weekend. Eczema flared after vaccine. Asthma has been stable.


VAERS ID: 1745654 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-01
Onset:2021-09-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Muscle spasms, Pain in extremity, Sneezing
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin d, multivitamin
Current Illness: none. Before the shot I had not been this ill for years.
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: For the first 2 days after the shot I had minimal side effects (sore arm, sneezing). The morning of Saturday, Sept 4 I woke up with back pain that progressed into the worst back spasms I''ve ever had and that didn''t subside until noon on Sunday, Sept 5, which at that point the back pain and spasms were intermittent until the evening of Monday, Sept 6. After Sept 6 the pain went away until I received my second COVID shot which will be in another report.


VAERS ID: 1746142 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-30
Onset:2021-09-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea, Fatigue, Laboratory test normal, Lipase normal, Myalgia, Pain, Pancreatitis, Sleep disorder, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: l-Thuroxine Tabs 50 mcg QD Colchicine 0.6 QD Allopurinol 100mg BID
Current Illness: Gout
Preexisting Conditions: Chronic Gout and hypothyroidism History of Hep C (2010) with interferon/antiviral treatment (2010) currently virus free
Allergies: Dairy
Diagnostic Lab Data: 28Sep21 Lipase 88 U/L
CDC Split Type:

Write-up: Second COVID vaccine given 30Aug21 and on 04Sep21 woked up around 130AM with severe abdominal pain. Soon after sever diarrhea and vomiting began (up to 10 times a day) . Also, extreme fatigue and body/muscle aches were experienced. Fatigue/body aches resolved aprox 12Sep but diarrhea and vomiting continued. Vomiting resolved 29Sep and diarrhea continues. HCP visited 22Sep21 , testing done but no diagnosis given. HCP visited again 28Sep21 with testing done and diagnosis of pancreatitis give.


VAERS ID: 1746575 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-31
Onset:2021-09-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lichen planus, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Started with an itchy rash that spread on my right leg. I went to dermatologist on 9/29/2021 and was told I had lichen planus. I have never had it before or anything like it.


VAERS ID: 1746583 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, Arthralgia, Diarrhoea, Dizziness, Eye inflammation, Fatigue, Headache, Loss of consciousness, Menstruation irregular, Migraine, Nausea, Oropharyngeal pain, Pain, Photophobia, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative, Viral infection
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Fertility disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune 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: Flintstone Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 9/27/21 9:09 AM SARS-CoV-2 by RT-PCR at Lab
CDC Split Type:

Write-up: Headache, fatigue, nausea, diarrhea, 102 fever, and body aches started 11 hours after the vaccine. Joint pain began the next day. Most of these symptoms improved after 4 days in bed, but the headache and fatigue have continued almost daily since the 2nd vaccine. This has also included migraines with light sensitivity and nausea. She has not had migraines previously. She has also had irregular menstrual cycles. She has had three menstrual periods within the past 6 weeks. Her normal cycle is 42 days. On 9/22/21, she had eye inflammation which she saw her eye doctor for. They believe it was just an ingrown eyelash. She felt lightheaded at this visit and passed out. She had also passed out after her first vaccine. She had an episode of feeling nauseated once at a doctor visit when she was younger, but had never passed out. On 9/24/21 she began having a sore throat, congestion, body aches, low grade fever, nausea, diarrhea, and continued headache and fatigue. She visited with a doctor on 9/25/21 who advised it was probably a viral infection, but that she should be tested for Covid. Later that night, she lost her sense of taste and smell. She was tested for Covid on 9/27/21. Her results were negative. Her symptoms have improved, but she continues to have headache, fatigue, congestion, and a sore throat.


VAERS ID: 1753247 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-08-24
Onset:2021-09-04
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Abortion spontaneous, COVID-19, Exposure during pregnancy, SARS-CoV-2 test positive, Thrombosis, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: Positive COVID test result on Sep 6 while at the ER
CDC Split Type:

Write-up: I was 9 weeks pregnant when I had my first COVID vaccine on Aug 24. My estimated due date was March 22, 2022. I started spotting 11 days after the vaccine, on Sep 4. The spotting gradually increased. Two days later to large blood clots and the blood loss was so much that I went to the ER. I miscarried on Sep 6 at 11 weeks pregnant. A D&C procedure was performed to complete the tissue removal. A blood transfusion was thought to be necessary but I did not end up having one.


VAERS ID: 1753422 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Encephalitis autoimmune, Memory impairment, Seizure
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Diabetic medications, blood pressure medications
Current Illness: Diabetes, HTN
Preexisting Conditions: Hx of follicular lymphoma s/p chemotherapy in remission
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Autoimmune encephalitis manifested in short term memory changes and new onset seizures


VAERS ID: 1753778 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions: Asthma Hypertension
Allergies: Augmentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, body aches, fatigue


VAERS ID: 1754750 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-03
Onset:2021-09-04
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaemia, Appendicectomy, Appendicitis, Appendicitis perforated, Candida infection, Clostridium difficile colitis, Haemoglobin decreased, Internal haemorrhage, Mineral supplementation, Post procedural drainage, Surgery, Transfusion
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Pseudomembranous colitis (narrow), Gastrointestinal perforation (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Xyzal
Current Illness:
Preexisting Conditions:
Allergies: Watermelon, pistachio nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Appendicitis, ruptured aappendix resulting in hospitalization and appendectomy 9/6/21. Complications of internal bleeding which necessitated transfusion and a second surgery. JP drain. Contracted c diff and thrush due to antibiotics. Developed anemia due to hemoglobin loss. Had treatment for c diff. Still with JP drain as of 10/1/21. Taking iron to treat low hemoglobin.


VAERS ID: 1755770 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-01-07
Onset:2021-09-04
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 - / OT

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

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

Write-up: body ache; discomfort; swelling on their left arm; got the third dose without being immunocompromised; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING, PAIN, DISCOMFORT, and OFF LABEL USE in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037F21A, 039K20A and 029K20A) for COVID-19 vaccination. The patient''s past medical history included Thyroidectomy. Concurrent medical conditions included Diabetes. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-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 OFF LABEL USE. On 05-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PERIPHERAL SWELLING. On an unknown date, the patient experienced PAIN, and DISCOMFORT. On 04-Sep-2021, OFF LABEL USE (got the third dose without being immunocompromised) had resolved. At the time of the report, PERIPHERAL SWELLING, PAIN, and DISCOMFORT outcome was unknown. Concomitant medications were not provided. Treatment information was not provided. This case was linked to MOD-2021-318414, MOD-2021-318331 (Patient Link).


VAERS ID: 1755805 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-30
Onset:2021-09-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Condition aggravated, Dyspnoea, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), 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: Herpetic whitlow (she has for over 20 years seems to have triggered after 1st dose)
Preexisting Conditions: Medical History/Concurrent Conditions: West Nile virus meningoencephalitis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: she still feels having shortness of breath; tachycardia; Her medical condition of Herpetic Whitlow that she has for over 20 years seems to have triggered after 1st dose; The same thing happened next night exactly same way; The same thing happened next night exactly same way; and chest pain.; 4 days later (04Sep2021), she woke up with gasping the breath; This spontaneous case was reported by a nurse and describes the occurrence of DYSPNOEA (she still feels having shortness of breath), TACHYCARDIA (tachycardia), CONDITION AGGRAVATED (Her medical condition of Herpetic Whitlow that she has for over 20 years seems to have triggered after 1st dose), DYSPNOEA (The same thing happened next night exactly same way) and CHEST PAIN (The same thing happened next night exactly same way) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 062E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included West Nile virus meningoencephalitis in May 2021. Concurrent medical conditions included Herpetic whitlow (she has for over 20 years seems to have triggered after 1st dose). On 30-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 04-Sep-2021, the patient experienced CHEST PAIN (and chest pain.) and DYSPNOEA (4 days later (04Sep2021), she woke up with gasping the breath). On 05-Sep-2021, the patient experienced DYSPNOEA (The same thing happened next night exactly same way) and CHEST PAIN (The same thing happened next night exactly same way). On an unknown date, the patient experienced DYSPNOEA (she still feels having shortness of breath), TACHYCARDIA (tachycardia) and CONDITION AGGRAVATED (Her medical condition of Herpetic Whitlow that she has for over 20 years seems to have triggered after 1st dose). At the time of the report, DYSPNOEA (she still feels having shortness of breath) and TACHYCARDIA (tachycardia) had not resolved, CONDITION AGGRAVATED (Her medical condition of Herpetic Whitlow that she has for over 20 years seems to have triggered after 1st dose), DYSPNOEA (The same thing happened next night exactly same way) and CHEST PAIN (The same thing happened next night exactly same way) outcome was unknown and CHEST PAIN (and chest pain.) and DYSPNOEA (4 days later (04Sep2021), she woke up with gasping the breath) 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 medications were reported. No Treatment information was reported. It was reported that first episode of chest and gasping was resolved within 10 minutes after patient sat up on her bed.


VAERS ID: 1755943 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-30
Onset:2021-09-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

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

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

Write-up: I was diagnose positive for Covid-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (I was diagnose positive for Covid-19) in a 49-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 30-Aug-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 COVID-19 (I was diagnose positive for Covid-19). At the time of the report, COVID-19 (I was diagnose positive for Covid-19) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.; Sender''s Comments: This case concerns a 49-year-old male patient with no relevant medical history reported who experienced non serious unexpected event of COVID-19. The event occurred approximately 5 days after the first dose of Spikevax. Rechallenge was unknown since no information regarding the second dose was disclosed. The benefit-risk relationship of drug is not affected by this report


VAERS ID: 1756044 (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: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest X-ray normal, Chest pain, Dizziness, Electrocardiogram, Feeling abnormal, Heart rate, Hypertension, Hypoaesthesia, Myocardial infarction, Ocular discomfort, Pain in extremity, Palpitations, Paraesthesia, Presyncope, Pulse abnormal, Vertigo
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Irritable bowel syndrome
Allergies:
Diagnostic Lab Data: Test Name: Chest Xray; Result Unstructured Data: Test Result:Normal; Test Name: EKG; Result Unstructured Data: Test Result:Normal; Test Name: Pulse; Result Unstructured Data: Test Result:80
CDC Split Type: USPFIZER INC202101224317

Write-up: Heart attack; almost fainted; Palpitations; Chest pain; Feeling abnormal; Lightheadedness; Numbness; Tingling of extremity; Eye discomfort; Pulse abnormal; Vertigo; Abdominal pain; Blood pressure high; Pain in arm; This is a spontaneous report from a contactable consumer (patient). A 37-year-old non-pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: Unknown), via an unspecified route of administration, administered in arm right on 20Aug2021 at 16:30 (age at vaccination 37-year-old) as dose 1, single for COVID-19 immunisation. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient medical history included IBS (irritable bowel syndrome) from an unknown date and unknown if ongoing. Concomitant medications included calcium carbonate, colecalciferol (VITAMIN D 2000), ascorbic acid, calcium pantothenate, copper sulfate, cyanocobalamin, ferrous fumarate, folic acid, magnesium sulfate, manganese sulfate, nicotinamide, pyridoxine hydrochloride, riboflavin, thiamine hydrochloride, zinc sulfate (PRENATAL-H) and ascorbic acid (VITAMIN C ACID) in two weeks. Prior to the vaccination, the patient was diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient had a sore arm and was fine for two weeks. On 04Sep2021 at 13:30, the patient had crushing chest pain, feeling of something popping inside her body, lightheaded, almost fainted, numbness and tingling in left arm and leg, felt something travel behind right eye and push it forward. The patient could see her abdomen pulse with heart beat and went to the Emergency Room thinking she was having a heart attack. The patient had chest X-ray and ekg (electrocardiogram) which were normal, pain in chest continued for a week. The events vertigo, dizziness, abdominal pain/bloating have continued. The patient had high BP, palpitations, and a pulse that wouldn''t go below 80. The patient had continued chest pain and feeling generally unwell. The patient was currently running tests with a cardiologist. The adverse event resulted in doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care. Seriousness criteria of the events was reported as hospitalization, medically significant. The patient did not received treatment for adverse events. The outcome of all events was not resolved. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow-up.


VAERS ID: 1756946 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen, ferrous sulfate, ibuprofen, multivitamin
Current Illness: Chronic trichomoniasis infection.
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient received the Janssen vaccine but was under 18 years old. The patient was 17 years old at the time of administration.


VAERS ID: 1757096 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-31
Onset:2021-09-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Menstruation irregular, Vaginal haemorrhage, Vaginal odour
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: When I started my period that weekend after getting my first shot, I experienced some unusual symptoms. My period only lasted 4 days instead of the usual 5. Also, the smell was much stronger and unpleasant. On September 18th, I experienced vaginal bleeding throughout the day. I was afraid my period had returned after only two weeks, but the vaginal bleeding only lasted a day. I have never experienced random vaginal bleeding prior to receiving the shot. Employee health informed me I would need medical expertise to support my claims so now, despite not having health insurance, I''m going to have to make an appointment with my old PCP to address this issue. I fear after having taken my second shot 9/21/2021 that my period for October will be strange as well.


VAERS ID: 1757323 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / 1 LA / IM

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

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

Write-up: The patient came in for her second dose and it was brought to our attention that she is not yet 18. I questioned the patient about any adverse events she may have experienced and she stated that there were none.


VAERS ID: 1757467 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Dyspnoea, Fatigue, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Immune-mediated/autoimmune 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: Vitamin D-3, sambucocl, Xyzal
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: 9-31-2021 covid test-negative 9-08-2021 covid test-negative 9-10-2021 covid test-negative 9-13-2021covid test-negative 9-17-2021 covid test-negative 9-20-2021 covid test-negative 9-27-2021 covid test-negative
CDC Split Type:

Write-up: I woke up on 9/2 and was congested so on 9/5 I decided to go get an iv at an iv bar just to help get me over what I was thinking was a cold or allergies. Then on 9/5 I went and got my first dose of the covid vaccine and on 9/6 I woke up with no smell and no taste at all. For the next week I was congested, it was hard to breathe and I was very fatigue. I did get covid tested since I lost my taste and smell and I was negative on all 4 of them in the next 12 days. Now, it is time for my second dose and I still have no smell or taste at all so the doctors don''t know if I should or should not get my second dose.


VAERS ID: 1758696 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthenopia, Computerised tomogram normal, Laboratory test normal, Magnetic resonance imaging normal, Ultrasound Doppler, Vasodilatation, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Per Patient Report - "labs, CT & MRI 9/7/21, caritarted (sic) arteries ultrasound 9/14/21."
CDC Split Type:

Write-up: Per Patient Report - ''Blurry vision, tired eyes, blood vessles slighty(sic) protruding. Went to urgent care. Sent to ER from urgent care. Had lab work, CT, MRI, All normal results. Followed up with Doctor (sic) and optimatrist (sic) next day. All results normal. Had ultrasound of caritated (sic) arteries. Results normal."


VAERS ID: 1759059 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-01
Onset:2021-09-04
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Blood test
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: N/A
Allergies: N/A
Diagnostic Lab Data: Blood work
CDC Split Type: vsafe

Write-up: I went for a normal check up. My blood pressure was up. My blood pressure is been up for about a month now.


VAERS ID: 1759529 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test normal, Cardiac flutter, Chest X-ray normal, Costochondritis, Electrocardiogram normal, Malaise, Monoplegia, Pain, Pain in extremity
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Tachyarrhythmia terms, nonspecific (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Lisinopril 10mg, exetimibe 10mg, D3, Bayer low dose
Current Illness: Cold a month prior, tested negative for covid
Preexisting Conditions: High cholesterol, blood pressure, aneurysm on aorta, calcium score of heart over 400
Allergies: Codeine, sulfa, ceflexin, bee stings
Diagnostic Lab Data: Ekg, blood and xray to rule out heart attack
CDC Split Type:

Write-up: Within 2 days had body ache felt like buss hit me. After a week my left arm started hurting and chest tight. Went to ER and was diagnosed with inflammation of chest wall and told that vaccination probably causing issues as ekg, blood test and xray came back fine. After 2nd dose including prior issues I have heart fluttering.


VAERS ID: 1759748 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

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

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

Write-up: PATIENT STATES SHE HAD A SEIZURE 2 DAYS AFTER RECIEVING THE VACCINE


VAERS ID: 1759764 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-18
Onset:2021-09-04
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: sulindac, omeprazole, simvastatin, metformin, lisinopril, glipizide, aspirin,
Current Illness: no other acute issues
Preexisting Conditions: chronic diabetes, chronic hyperlipidemia, hypertension
Allergies: PCN, tetracyclines, tree nuts, flexeril
Diagnostic Lab Data: test confirmed on 9/8/2021, now recovered and follow up test negative 9/24/21
CDC Split Type:

Write-up: had breakthrough infection of covid 19


VAERS ID: 1760246 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Heart rate irregular, Pain, Sleep disorder
SMQs:, Cardiac arrhythmia terms, nonspecific (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: Levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the first shot with no problems on August 13, 2021. My second vaccine was on September 3, 2021 did not have a reaction till the following day I had extreme head pain throbbing pressure and still continuous fast irregular heartbeats that wake me while sleeping almost everynight. I have a pulse oximeter and my heart rates is in 100 to 120 range while sleeping. Sometimes takes my breath away.


VAERS ID: 1761555 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-25
Onset:2021-09-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: An ultrasound was used to determine that I had a blood clot in my upper left arm. DVT.
CDC Split Type:

Write-up: 2 weeks or so after the vaccine my arm started hurting. I thought I had slept on it funny and ignored the pain for some time. By September 18 the pain was worse. On September 24 I went to the emergency room and was diagnosed with deep vein thrombosis of the left arm.


VAERS ID: 1761617 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761626 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Unknown  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761629 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761634 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761639 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761642 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761821 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Diarrhoea, Dizziness, Feeding disorder, Migraine, Myalgia, Stool analysis, Urine analysis, Vomiting, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wasn''t taking anything
Current Illness: No I would say I was doing pretty good health wise
Preexisting Conditions: No
Allergies: No, Doctacylin doesn''t agree with me
Diagnostic Lab Data: ER and Doctors office did blood work, urine and stool samples, CT scans. I have a colonoscopy and endoscopy an appointment set for next week.
CDC Split Type: vsafe

Write-up: Starting that day about 20minutes after the vaccine I got severe stomach cramps which culminated in vomiting diarehea and migraine and other typical symptoms like achy muscles and dizziness but those went away by the 2/3rd day. But the vomiting and diarrhea hasn''t gone away and its be like a month. On the 6th I went to the ER and they tested me for a wide variety of things and didn''t find anything and sent me home. I went to the walk in the next morning and they tested for the same things to include stool, urine and blood samples. they didn''t find anything. a week went by and it didn''t get any better. they said it was probly a virus i got the same day. i wasn''t getting any better but vomiting and stomach cramps were getting worse. went back to the ER and they did ct scans and checked my gallbladder and appendix and they didn''t find anything. went to my Doctor and they sent me to the GI doctor because they didn''t find anything. The GI doctor I went to last week is sending me to do a colonoscopy and endoscopy next week. stomach cramps are so severe that i throw up and have lost 20-25 pounds over this last month since i''m unable to eat anything. Again the normal typical symptoms only lasted 3 days. but the other gi issues have persisted.


VAERS ID: 1762123 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-04
Onset:2021-09-04
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Gallbladder disorder, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gallbladder related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (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: 12 years ago, flu shot- really sick. I got better on my own. The doctor said I probably had an allergic reaction to it.
Other Medications: Pristiq 50 mg od morning Wellbutrin 50 mg od Seroquel 100 mg od Ativan 1 mg as needed Nexium 40 mg od Trazodone 50-100 mg as needed but usually everyday
Current Illness: I had cold symptoms, sore throat and coughing , tested negative for COVID-19, a month prior to 2nd Dose of Moderna. Every year I get cold symptoms 4 or 5 times a year. It''s a normal state for me to have constant cold symptoms.
Preexisting Conditions: celiac disease chronic pain -undiagnosed chronic migraine chronic pain in muscle and joints -undiagnosed (I see a doctor for it) eosinophilic esophagitis chronic recurring cystitis in my bladder seborrhea dermatitis eczema
Allergies: penicillin sulfa drugs ceclor pasticcios lactose to celiac
Diagnostic Lab Data: 10/11/2021- scan appointment
CDC Split Type: vsafe

Write-up: Around 09/04 or 09/05, I had nausea and vomiting and pain in my right shoulder and down to my shoulder blade. The symptoms lasted for like 5 days, I adjusted my diet and my symptoms changed a little bit. I notice what was happening, and I figured out it was my gall bladder because I have had issues with my gall bladder before . I changed my diet and the symptoms alleviated a little . 09/20/20 - I had an appointment with my gastroenterologist. He said my symptoms were consistent with gall bladder disfunction. He will do more diagnostics to confirm it. 10/11/ 2021 I have an appointment to have a scan to do some diagnostics, and then monitor it from there.


VAERS ID: 1762237 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dehydration, Headache, Hyperhidrosis, Nausea, Pyrexia, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow)

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

Write-up: Nausea and vomiting for 7 days straight, fever of 102 for 3 days, extreme chills and sweats to the point of vomiting more, headaches for all 7 days, went to ER on day 4 for dehydration and vomiting doctor took X-ray and gave nausea medicine.


VAERS ID: 1762882 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-01
Onset:2021-09-04
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac disorder, Catheterisation cardiac, Chest pain, Computerised tomogram, Echocardiogram, Electrocardiogram, Palpitations, Stress cardiomyopathy
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Other ischaemic heart disease (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ECHOCARDIOGRAM/ CARDIO CATHETERIZATION/EKG/CT
CDC Split Type:

Write-up: CHRONIC PALPITATIONS PRIOR TO CHEST PAIN/CARDIAC EVENT LEADING TO TAKOSUBO CARDIOMYPATHY DIAGNOSIS/ HOSPITALIZED FOR 4 DAYS/ CARDIAC CATHETERIZATION. MEDICATION AND FOLLOW UP SPECIALISTS APPOINTMENTS.


VAERS ID: 1764715 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aggression, Aphasia, Asthenia, Blood pressure increased, Dizziness, Dyspnoea, Fall, Hypoaesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hostility/aggression (narrow), Hypertension (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 25mcg
Current Illness: Hypothyroidism, GERD
Preexisting Conditions: Anxiety
Allergies: Cipro, daypro, flagyl, all fresh fruit and vegetables
Diagnostic Lab Data:
CDC Split Type:

Write-up: Walking back to car moving arm left arm went numb, then left hip, then left leg. (Day of dose 1) Over the course of the last month SOB, occasional dizziness, one fall with weakness, mild aphasia and elevated blood pressures October 4 also both doses mild feelings of aggression days post injection up to 10 days


VAERS ID: 1764757 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-29
Onset:2021-09-04
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


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