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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 278 out of 8,010

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VAERS ID: 1671910 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-31
Onset:2021-09-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Pain in jaw
SMQs:, Osteonecrosis (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: Advil pm taken night before
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in front of left leg, to the right of shin area. No treatment. Jaw pain when making side to side movement


VAERS ID: 1672285 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bundle branch block, Chest pain, Electrocardiogram, Fatigue, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Conduction defects (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Sudden onset of chest pain. Positive vomiting. Duration of 3 hours prior to arrival of emergency department. Nausea, vomiting, fatigue, day prior.


VAERS ID: 1673672 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-28
Onset:2021-09-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Cardiac flutter, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow), Dehydration (broad)

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

Write-up: My heart was beating and fluttering so fast I was quite alarmed. It did stop a couple of seconds cans later I have been experiencing light fluttering.


VAERS ID: 1673675 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN U7328AA / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dizziness, Tachycardia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Shakiness-Mild, Systemic: Tachycardia-Medium, Additional Details: Refer pt to ER due to tachycardia and anxiety.


VAERS ID: 1673677 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN U7328AA / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dizziness, Tachycardia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Shakiness-Mild, Systemic: Tachycardia-Medium, Additional Details: Refer pt to ER due to tachycardia and anxiety.


VAERS ID: 1673680 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Seizure, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Seizure-Severe


VAERS ID: 1673681 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild


VAERS ID: 1674296 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium


VAERS ID: 1674300 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Confusional state, Dysphagia, Dyspnoea, Hyperventilation, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Confusion-Medium, Systemic: Hyperventilation-Medium


VAERS ID: 1674304 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site reaction, Mobility decreased, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Pt reported her upper arm was numb and unable to move it. She was able to move her fingers. She reported numbness as well as pins and needle feelings around the injection site / upper arm area.


VAERS ID: 1674305 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad)

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

Write-up: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Additional Details: throat became red. redness dissipated after epi pen given


VAERS ID: 1674308 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Visual Changes/Disturbances-Mild, Additional Details: Patient fainted at observation area


VAERS ID: 1674309 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1674310 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: Patient stated she was having numbness (pins and needles sensation) through arm and fingers during the 15 minute observation period. No other symptoms or presentation of allergy. No shortness of breath or anaphylactic like reaction.


VAERS ID: 1674311 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium


VAERS ID: 1674317 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury, Paraesthesia, Seizure, Skin laceration, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Seizure-Medium, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: HE SEIZED WHILE WAITING. HE FELL DOWN THE CHAIR AND HIT HIS HEAD. THERE WAS A LACERATION ABOVE HIS RIGHT EYEBROW. HE SAT DOWN ON A CHAIR ABOUT 15 MIN AFTER SEIZING AND PROCEEDED TO VOMIT IN A BAG. CONCERNED, HIS PARENTS DECIDED TO TAKE HIM TO ER.


VAERS ID: 1674321 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Chest pain, Dizziness, Panic attack, Paraesthesia, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Shakiness-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: she was very anxious and got dizzy after the vaccine. she said it almost felt like a panic attack. had her sit on the floor, she had water and granola bar and started feeling better pretty quickly. after about 30 minutes she was a lot better and felt fine and then left with her friend.


VAERS ID: 1674322 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Nausea, Presyncope, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Medium, Additional Details: Called paramedics Patient taken to hospital--was told it was vagal response to vaccination


VAERS ID: 1674323 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Nausea-Medium


VAERS ID: 1674326 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-01
Onset:2021-09-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: He developed severe headache and fatigue on day 1 then by day 2 he was reporting stabling chest pain but no SOB. I have been treating him with ibuprofen 800mg q 4-6 hours, vitamins and fluids. At the time of this report I have not taken him in for any tests.


VAERS ID: 1674470 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Headache, chills, fever (101 degrees), fatigue, arm pain


VAERS ID: 1674471 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-09-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

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

Write-up: Huge bruise on the right side of my abdomen just above the hip bone. Large bruise with lots of blood in the center of it.


VAERS ID: 1674473 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / UNK LA / IM

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

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

Write-up: chills, body aches, fever


VAERS ID: 1674478 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-27
Onset:2021-09-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / SYR

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

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

Write-up: Severe hives 7 days later


VAERS ID: 1674480 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: patient reported that she has felt light headed or fainted with previous vaccinations or when giving blood
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient presented to pharmacy for covid vaccine - she filled out form and indicated that she has had reactions following vaccinations in the past - I inquired to see what kind of reactions - patient said she sometimes has felt light headed or fainted before but it hasn''t happened in a long time - she also said she has given blood recently and was fine without issues - Following vaccine administration, patient said she wasn''t feeling well several minutes later and was feeling faint - I offered water or for her to lie down - pt then fainted sitting in the chair and remained sitting in chair - I stayed with patient while tech called 911 - patient was out for about 30 seconds then came back and said she felt nauseous - patient was able to answer questions about who she was and her date of birth right away - patient remained in chair and drank water - EMS arrived and assessed patient - after talking to EMS and resting for about 20 minutes, patient was fine and left pharmacy in normal state


VAERS ID: 1674484 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-01
Onset:2021-09-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Rash covering entire body


VAERS ID: 1674500 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-28
Onset:2021-09-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site nodule, Injection site swelling, Pruritus, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Probiotic Vitamin C Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: Lobster Crab
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid arm Hard, swollen knots at injection site and below. Red rash Itch Pain Warm to touch


VAERS ID: 1674520 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac flutter, Injection site pain, Pollakiuria
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Extravasation events (injections, infusions and implants) (broad), Tachyarrhythmia terms, nonspecific (narrow)

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

Write-up: Frequent urination beginning at 11:30pm and continuing until 8:am, even though not well hydrated. Minor heart fluttering one hour after injection, lasting only thirty minutes. Very sore at injection site.


VAERS ID: 1674523 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-03
Onset:2021-09-03
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Not a client of this vaccine provider (spouse of a current client of this provider); seen at medical office and admitted to Hospital.
Current Illness: Not a client of this vaccine provider (spouse of a current client of this provider); seen at medical office and admitted to Hospital.
Preexisting Conditions: Not a client of this vaccine provider (spouse of a current client of this provider); seen at medical office and admitted to Hospital.
Allergies: Not a client of this vaccine provider (spouse of a current client of this provider); seen at medical office and admitted to Hospital.
Diagnostic Lab Data: POSITIVE COVID-19 TEST
CDC Split Type:

Write-up: TESTED POSITIVE FOR COVID-19 AS PER 09/03/21 NOTIFICATION BY HIS SPOUSE AND ADMITTED TO HOSPITAL.


VAERS ID: 1674537 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram normal, Heart rate increased, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none recorded in the pharmacy
Current Illness: patient said no illnesses
Preexisting Conditions: none reported
Allergies: none recorded
Diagnostic Lab Data: EKG done and had normal EKG
CDC Split Type:

Write-up: Reported pressure on the left side of chest. Strong fast heart beat , Felt pain as well


VAERS ID: 1674551 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-01
Onset:2021-09-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Deep vein thrombosis, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: None
Current Illness: None
Preexisting Conditions: Morbid obesity, stage 1 endometrial cancer
Allergies: None
Diagnostic Lab Data: Ct chest showing pe on 9/3/21 Lower extremity duplex showing dvt on 9/2/21
CDC Split Type:

Write-up: Dvt and pulmonary embolism


VAERS ID: 1674552 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Abnormal uterine bleeding
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: levonorgestre-ethinyl estreadiol 100mcg-20mcg
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Abnormal uterine bleeding


VAERS ID: 1674564 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-16
Onset:2021-09-03
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest X-ray abnormal, Chills, Confusional state, Disorientation, Fatigue, Hypoxia, Lipase normal, Lung opacity, Lymphocyte percentage decreased, Neutrophil percentage increased, Platelet count decreased, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None identified
Preexisting Conditions: DM 2, HTN, Peripheral vascular disease, atherosclerosis of aorta and right leg, coronary artery disease
Allergies: NKDA
Diagnostic Lab Data: PLT 128, Neutrophils 79%, Lymphs 14 %, Lipase 104, CRP 2.8, CXR shows airspace opacities in the right lung, O2 SATs 91% on RA, SARS-COV-2 tested positive.
CDC Split Type:

Write-up: Confusion, disorientation; patient was getting ready to leave her home but did not know what day is is or where she was going. Also reports feeling tired and having chills. Noted to have hypoxia here in ER.


VAERS ID: 1674566 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Temperature intolerance, Tinnitus
SMQs:, Hearing impairment (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metropolol 25 mg Xyzal 5 mg L-Carnitine 1000mg
Current Illness: Tachycardias Asthma Allergies Carnitine Deficiency with Hypoglycemia
Preexisting Conditions: Carnitine Deficiency with Hypoglycemia
Allergies: Aspirin Seafood
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within 12 hours of receiving the second dose I started with severe joint pain, intolerance to cold and increased pre-existing tinnitus.


VAERS ID: 1674570 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Dizziness, Dysstasia, Headache, Neck pain, Pain, Photopsia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Retinal disorders (narrow), Vestibular disorders (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Culturelle probiotic Lo-loestrin FE (birth control)
Current Illness: None
Preexisting Conditions: None
Allergies: Eggs, sulfa, amoxycillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Racking chills, fever, head and neck ache: 10 hours post-vaccine to 18 hours post-vaccine Body aches, fever, dizziness, difficulty rising: 12 hours post-vaccine to 24 hours post-vaccine. Flickering vision/appearance of flashing lights and acute joint pain: 30 hours post-vaccine


VAERS ID: 1674577 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Shaking, trembling hands after second Moderna vaccine
Other Medications:
Current Illness: Cough, fatigue, swollen glands; cold sore
Preexisting Conditions: Psoriasis, herpes simplex
Allergies: Levaquin, penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen, hard, red, warm bump 2.5 inches long and 1 inch wide on arm?not at injection site, but starting 1 inch lower on the arm and extending down


VAERS ID: 1674578 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Oedema peripheral, Pain
SMQs:, Cardiac failure (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Headache, sore throat, fatigue, 60, 03/12/2021 and 04/02/2021, Covid-19 Pfizer-Biotech
Other Medications: Low Dose Naltrexone, Acyclovir, Famotidine, Prilosec,
Current Illness: Herpes Simplex Virus outbreak. Ehlers-Danlos Syndrome, Mast Cell Activation Disease, Raynaud''s Disease, Dry Eye Disease, Allergic Rhinitis, CCI, Asthma, Aspergillosis infection, IBS, Gut Dysmotility, Acid Reflux, Dysautonomia, Tinnitus, Skin Cancer, Guttate Psoriasis, Tricuspid Valve Regurgitation, Palpitations, Edema, Torn Left Miniscus
Preexisting Conditions: Herpes Simplex Virus, Ehlers-Danlos Syndrome, Mast Cell Activation Disease, Chronic Epstein-Barr Virus, Raynaud''s Disease, Dry Eye Disease, Allergic Rhinitis, CCI, Asthma, Aspergillosis infection, IBS, Gut Dysmotility, GERD/Acid Reflux, Dysautonomia, Tinnitus, Skin Cancer, Guttate Psoriasis, Tricuspid Valve Regurgitation, Palpitations, Edema, Torn Left Knee Miniscus
Allergies: Contrast Iodine Dye, Shellfish, MSG, Dairy, Chicken Eggs, All chemical odors; Perfumes/Fragrances/Scented Products/Pesticides/Cleaning products/Bleach/Ammonia and Smoke, Folic Acid food/drink additive, Food colorings, Yeast, Legumes, Tomatoes, Peppers, White Potatoes, Eggplant, Bananas, Avocado, Chocolate, Beef, Pork, Natural Flavor additives, Citrus.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severely and ongoing swollen and painful armpit radiating down left arm and left breast and up left side of neck and shoulder.


VAERS ID: 1674580 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dizziness, Palpitations, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: not known
Preexisting Conditions: not known or not listed in form
Allergies: yes know allergic reaction to allergy shots and few other things as per patient, - none listed in IMZ form
Diagnostic Lab Data: Patient visited her allergist nearby , allergist advised her to see ER, Patient had taken 2 Benadryl and felt bit better after few hours, but felt symptoms coming back next day morning, that''s when she reported to Pharmacist
CDC Split Type:

Write-up: patient described as " Heart rate, felt like racing HR, anaphylaxis, tongue swelling, Felt like passing out"


VAERS ID: 1674593 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-01
Onset:2021-09-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Lethargy, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft Buspar Synthroid Bupropion
Current Illness: Felt feverish and achy for 2 days
Preexisting Conditions: No
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Developed reddish spots on my forehead and few on my face, they are flat and do not itch. Had a low fever . Very achy and lethargic


VAERS ID: 1674594 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3194 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Palpitations, Paraesthesia oral, Tremor, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratadine, Sertaline, Flonose, Monkulast, Probiotic, Womens daily mulitivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Cats, dogs, trees, grass, dust, mold
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Between 45-60 minutes after the dose my heart began to race, vision was blurred, I was dizzy and felt light headed. I then began to tremble. I took 50mcg of Benadryl at the onset of tongue tingling. I have a history of biphasic anaphylaxis from allergy shots and carry an epipen. I had another reaction this morning (9/4). Heart racing, dizzy, again with the Benadryl symptoms have subsided.


VAERS ID: 1674599 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

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

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

Write-up: ABOUT 10 MINUTES AFTER GETTING THE SECOND DOSE PATIENT FAINTED , BUT GAINED CONSCIOUSNESS IMMEDIATELY AND BLOOD PRESSURE WAS IN NORMAL RANGE.


VAERS ID: 1674603 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NOT KNOWN
Preexisting Conditions: NOT KNOWN
Allergies: NKA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PT DID NOT INDICATE THAT IT WAS HER SECOND DOSE ON THE FORM. THE FIRST DOSE WAS ON 8/22/2021 SECOND DOSE WAS GIVEN TOO EARLY ON 9/3/2021. PT WAS CALLED FOR FOLLOW UP. NO ANSWER


VAERS ID: 1674604 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Dysgeusia, Feeling abnormal, Feeling cold, Feeling hot, Headache, Pain, Penis disorder, Pyrexia, Tenderness
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 20mg Omeprazole daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I felt quite decent subsequent to the shot. Approximately 5-6 hours post shot, I began to feel freezing cold. I had a burning sensation in my penis which was not fun for about 1 hour. Afterwards, I started feeling very, very warm. My temperature went up to ~ 103.2. My body felt as though I had been beaten with a bat. My head was tender to touch, and it was painful while taking a shower. I had a strange taste in my mouth, seemingly, metallic. I slept horribly all last evening. I sweat all night, and I could not stay asleep for more than 2-3 hours at a time. I woke up with horrible chest pain (left side), and I thought that I was having a heart attack. I still have a fever, however, it has dissipated to ~ 100.4. I have never in my life felt like this, and I regret taking this vaccine 100%. This is the only thing in my life that I have ever regretted, so to say that I am happy would be a complete and utter falsification. I now have the worst headache that I have ever had, and quite honestly, feel like waking out into traffic? This was a disaster, and I?m very regretful.


VAERS ID: 1674614 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure abnormal, Discomfort, Hypotension, Nausea, Pain in extremity, Pallor, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: 10 hours post injection, L arm began feeling sore, as expected. Normal night routine, went to bed at 12 a.m. 3: 30 a.m., I began feeling tingles and heaviness throughout my whole body, extremely nauseated and needing to use the restroom. After using the restroom, I noticed I was extremely pale. Thankfully my brother was awake, after calling for assistance, he took my blood pressure and reported 80/40- very abnormal. After 15-20 minutes, my BP started increasing and I started to feel better. Over all, my BP dropping that low has never happened and I am scared to take my second dose.


VAERS ID: 1674619 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Mouth swelling, Nausea, Oropharyngeal pain, Pruritus, Rash, Rash pruritic, Swelling face, Swollen tongue, Tenderness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Allergic: Rash Generalized-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Pain when touching skin and when scratching an itch on the skin-Severe, Systemic: Nausea-Mild, Additional Details: Patient has rash that started on wrist and has spread over her entire body that is itchy and painful. She has experienced some facial swelling, throat soreness, and nausea. No difficulty breathing nor throat tightness.


VAERS ID: 1674631 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-20
Onset:2021-09-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site reaction, Pain, Pain in extremity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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: Losartan, Crestor, Prilosec, Caltrate, Vitamin D-3, Aller-tec
Current Illness: None
Preexisting Conditions: Arthritis, sleep apnea
Allergies: Pine Nuts, Brazil Nuts, Prednisone (hives & rash), Dipyridamole (hives & rash)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain in upper left arm, checked to see large red welt (3" diameter) around injection site. More pain when trying to lift arm.


VAERS ID: 1674632 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Chills, Feeling cold, Hallucination, visual, Headache, Hypoaesthesia, Injection site discomfort, Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Myalgia, Parosmia, Pyrexia, Taste disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, clonidine, prilosec, asa, hctz,
Current Illness: None known
Preexisting Conditions: Hashimoto hypothyroid, htn, morbid obesity, gerd
Allergies: Bee stings
Diagnostic Lab Data: None done. I, myself am reporting the reaction. I am a RN. I have not seen my PCP yet, I am monitoring it.
CDC Split Type:

Write-up: After getting 2nd vaccine, during the night I had: Chills & fever, temp. 101. Freezing, then I''d get so hot, felt like skins on fire, severe constant headache, muscles ache, feet and hands get numb and Tingley now & then, visual hallucinations - seeing grim reaper in peripheral vision. Smell - hyper. Taste - cream Soda - horrible, The evening after 2nd vaccine, left arm started to get stiff, edematous, and hurt. My arm progressed with large red, hot, hard edematous, painful, itchy, with orange peel look and feel to skin. Monitoring arm at this time & applying cool compress, advil prn. If it gets worse or lasts really long will see doctor


VAERS ID: 1674640 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra, over-the-counter multivitamin
Current Illness: Glioblastoma
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, fever, headache, weakness


VAERS ID: 1674643 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Salivary gland enlargement, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pyridostigmine empagliflozin losartan glycopyrrolate cholecalciferol phentermine rosuvastatin Creon metformin aspirin
Current Illness:
Preexisting Conditions: myasthenia gravis diabetes hyperlipidemia
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Neck swelling began the day after receiving the vaccine. Vaccine was given the left arm, swelling was in right side of neck. He presented to the ED approximately 48 hours after vaccination with profound swelling in right neck. CT scan showed swelling of submandibular gland without any abscess or sign of infection.


VAERS ID: 1674651 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dyspnoea, Erythema
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pfizer Covid19
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced anaphylaxis approximately 5 minutes after vaccine was administered. Anaphylaxis was presented with facial redness and trouble breathing. Following the observation of signs/symptoms of anaphylaxis, one Epinephrine 0.3 mg auto-injector and one dose of diphenhydramine was administered and EMT was alerted. Patient was picked up by EMT a few minutes after while patient was still conscious and transferred to Hospital for further evaluation.


VAERS ID: 1674668 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Pain, Rash
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Shortness of breath, chest pain, rash on both arms, body aches


VAERS ID: 1674670 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-26
Onset:2021-09-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / -

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

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

Write-up: 8 days after my first round my injection site became swollen. I didn?t have any swelling prior. The swollen area is itchy and painful to the touch.


VAERS ID: 1674671 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Mucous stools
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Propranolol, Xarelto, Prednisone, Atorvastatin, Senna, Tylenol as needed
Current Illness: N/A
Preexisting Conditions: Osteoarthritis in bilateral knees
Allergies: Ciprofloxin, Reglan and Boniva
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Mucus stools


VAERS ID: 1674672 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Back pain, Diarrhoea, Dizziness, Heart rate irregular, Pain in extremity, Peripheral swelling, Somnolence, Swelling, Vision blurred
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Strong dizziness 15 minutes after getting the second vaccine, blurry vision. I also had diarrhea, fast heartbeat that comes and goes. Around 5:00pm I felt very weak and sleepy. The next day I woke up with pain and swelling in my legs and in the middle of my back.


VAERS ID: 1674673 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-31
Onset:2021-09-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Fatigue, Heart rate increased
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), Cardiomyopathy (broad), 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: Topamax, Phentermine, Tylenol and/or Ibuprofen
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rapid heart rate, chest feels heavy, shortness of breath, dizziness, still fatigued after 4 days, I have to take deep breaths to feel like I?m getting enough air


VAERS ID: 1674680 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Chest discomfort, Dysgeusia, Muscle tightness, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Taste and smell disorders (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Montelukast SOD, Benadryl, full spectrum spearmint leaf, Ginger call Ma evening primrose, omega-3 fish oil, Loratadine
Current Illness: None
Preexisting Conditions: Eczema, prediabetes
Allergies: Sesame seed
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nickel taste, throat itching, mild anaphylaxis, chest tightening, upper right back tightening


VAERS ID: 1674690 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Dry throat, Nausea, Oropharyngeal discomfort, Sensation of foreign body, Somnolence, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Patient reported an unusually dry throat 15 minutes after vaccine. She was given water and her observation period was extended. At 30 minutes after vaccination she reported a lump in her throat and felt a strange sensation when swallowing. She was given diphenhydramine 50mg IM in right deltoid. She then experienced dizziness, nausea, chills and was visibly shaky. She was observed for about 90 minutes and we discussed the best option was for the EMS squad to evaluate her. Upon follow up at 8pm she was drowsy, shaky, and still had the lump in her throat . She had opted not to be transported to the hospital after EMS evaluated her in the ambulance. Her husband came into store at 8:30 pm to get diphenhydramine in oral form which I had suggested she take for the next 24-48 hours. On 9/4/21 I spoke with patient around 2pm and the lump in her throat had decreased and she was still taking diphenhydramine.


VAERS ID: 1674698 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-09-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Eye disorder, Eye irritation, Facial discomfort, Fatigue, Immunodeficiency, Pyrexia, Taste disorder
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Corneal disorders (broad), Retinal disorders (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: lysinopril
Current Illness:
Preexisting Conditions: In remission from lymphoma, treated in 2019
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had a pretty extreme response to booster. Ran a fever for three days after shot and was very fatigued until Friday after getting the shot on Monday. Started to have altered taste around Thursday of the same week. On September 2nd, started feeling an irritation in my right eye. By Thursday night, face was asymmetric and right eye clearly not blinking, could not smile. Was diagnosed on Friday, September 3rd with Bell''s palsy.


VAERS ID: 1674705 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-30
Onset:2021-09-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial flutter, Blood magnesium, Chest X-ray, Electrocardiogram, International normalised ratio, Metabolic function test, N-terminal prohormone brain natriuretic peptide, Prothrombin time, Red blood cell count, Troponin, White blood cell count
SMQs:, Supraventricular tachyarrhythmias (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: losartan, bupropion, tadalafil, flutiasone, testosterone
Current Illness: none, except mild seasonal allergy
Preexisting Conditions: hypertension, osteoarthritis, mild seasonal allergy (primarily sinusitis)
Allergies: none known
Diagnostic Lab Data: complete blood cell count, comprehensive metabolic panel, magnesium level, PROBNP, Prothrombin time/INR, Troponin, chest x-ray, EKG 2 times.
CDC Split Type:

Write-up: Dx: atrial flutter I monitored pulse on iWatch during and after regular 3 mile hike. Pulse was higher than usual towards end of hike (up to 168 when usually not over 130). Hike ended at 10:40 AM and pulse stayed elevated in 130-140 range. I called advice nurse about 2 pm and went to urgent care where EKG was done and they sent me to Hospital ED where tests done and IV metoprolol administrated between 5:34 and 6 when oral tartrate version added. Pulse returned to normal range by 6:30 and I was discharged about 8:30. Referred to cardiologist for followup.


VAERS ID: 1674726 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red, itchy, swollen spots in both arms and on body


VAERS ID: 1674727 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient''s parent reported a slight rash to cookies eaten the night previous but parents stated it went away with topical cream and patient doesn''t have any allergies per them.
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came in about 1.5 hours after vaccine stating there was a rash on his back/torso. Patient took oral benadryl for the rash. Parents decided to go to the ER just incase to make sure the patient was okay. Per Father the next day the he reported that by the time they got to the ER the rash was over 50% gone. The ER recommended Zyrtec and benadryl if needed later and said it was correct patient took the first does of Benadryl at onset of symptoms as directed. Patient is fine today and per father didn''t need any additional benadryl.


VAERS ID: 1674732 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Disturbance in attention, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Fever, chills, throbbing headache, difficulty concentrating, loss of appetite. No treatment was taken other than remaining well hydrated. Roughly 96 oz of water (three 32 oz bottles) was consumed throughout the duration of the symptoms, which are described below. Chills and headache started at 10am (17.5 hours after injection). Difficulty concentrating started at 2pm (21.5 hours after injection). At 3:15pm temperature was taken and found to be 102 F. All listed symptoms continued until fever started to break around 9:30pm (28 hours after injection). At which time it was measured to be 100.5 F. The following morning all symptoms were minor or gone.


VAERS ID: 1674733 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Dyspnoea, Electrocardiogram normal, Full blood count normal, Laboratory test normal, Myocardial necrosis marker normal
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? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Amoxil
Current Illness: Dental infection
Preexisting Conditions: Hypertension, sleep apnea
Allergies: Morphine
Diagnostic Lab Data: CXR, EKG, Cardiac enzymes (2), CBC, chemistry - all unremarkable.
CDC Split Type:

Write-up: Chest pain and dyspnea.


VAERS ID: 1674740 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered, Influenza like illness, Nasal congestion
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: Dicyclomine, Latuda, Protonix, Lamotrigine, Advil 2
Current Illness: None
Preexisting Conditions: Asthma, Bi-polar
Allergies: Tomatoes, Zanax, Depekote
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Was given a larger dose. 0.5, rather then the normal 0.3, I feel stuffed up head, and slight flu like symptoms, roughly 22 hours after given wrong dosage.


VAERS ID: 1674744 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dysphagia, Dyspnoea, Headache, Paraesthesia, Tongue dry
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Anxiolytic
Current Illness: None
Preexisting Conditions: Reported panic attacks and anxiety
Allergies: Penicillin, rocephin, Latuda
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At approximately 1052 client informed RN that her, "tongue felt dry" and she was "having difficulty swallowing". Client denied having chest pain, headache, dizziness, tingling of face, difficulty breathing, or shortness of breath. At 1055 first set of vitals taken: BP 180/100, HR: 70, RR: 18, client A&Ox4, Lead RN visualized client''s oropharynx which was red with slight swelling, skin was warm, dry and normal color for ethnicity. Client denied any pertinent medical history. Client stated she has a history of "panic attacks and anxiety" and stated she was, "feeling very anxious about the vaccine". Client stated she had history of anaphylaxis to penicillin, rocephin and an antidepressant she couldn''t remember the name of, possibly Latuda. Client reported she takes an anti-anxiety medication but she couldn''t remember the name. Client ambulated to zero gravity chair without assistance or incident. At 1100 client stated her throat still felt tight and continued to have difficulty swallowing, client continued to deny SOB, or difficulty breathing, capillary refill <2 seconds, skin warm, dry and normal color for ethnicity. Lead RN educated client on need for further intervention which client consented to. At 1103 EMS activated by co-lead RN. At 1104 Lead RN administered 50mg IM diphenhydramine to client''s right deltoid. At 1107 BP 138/98, HR 74, RR 12, A&Ox4, skin warm, dry and normal color for ethnicity, client denied SOB, CP, HA, dizziness, difficulty breathing. Client stated her throat was, "feeling better". At 1111 care turned over to EMS. At 1115 client signed AMA from EMS. 1121 vitals taken BP 136/90, HR 70, RR 16. Client reported resolution of throat tightness, dry mouth and difficulty swallowing. Client stated she felt, "much better". Lead RN educated client on ED precautions. At 1124 client ambulated away from the site accompanied by her husband, on her own accord and with a steady gait.


VAERS ID: 1674749 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered, Influenza like illness, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions: Celiac Disease, and Bi-polar
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Was given a larger then recommended dose, at 0.5 rather 0.3, and within 14 hours started feeling severe flu like symptoms including aches, pains, and vomiting.


VAERS ID: 1674750 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient is not on any of the items listed
Current Illness: no illnesses the month prior to vaccination
Preexisting Conditions: no chronic or long-standing health conidtions
Allergies: Patient has no known allergies
Diagnostic Lab Data: no medical tests were performed - only BP and heart rate were monitored
CDC Split Type:

Write-up: Patient fainted about 2 minutes after the vaccine was administered.


VAERS ID: 1674751 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Severe abdominal pain after flu vaccine
Other Medications: Flecainide 100mg qd, Atenolol 50mg qd, Fenofibrate, multivitamin
Current Illness: None
Preexisting Conditions: Hypercholesterolemia Hypertension Atrial fibrillation caused by alpha gal
Allergies: Alpha gal Statins Blood thinners ACE-i
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever higher than 101.5 Widespread arthralgia and myalgia Abdominal pain, nausea Headache


VAERS ID: 1674758 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-28
Onset:2021-09-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Menometrorrhagia, Menstrual disorder, Thrombosis, Ultrasound pelvis normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Seasonal, cat and food:orange
Diagnostic Lab Data: 09/03/21, blood work test and ultrasonic pelvic- transabodminl and transvaginal done, results comeback normal.
CDC Split Type:

Write-up: Menstrual cycle begins 5 days early, 09/02/21. Excessive bleeding and blood clots, 09/02/21 to 09/03/21. Seek medical attention, 09/03/21.


VAERS ID: 1674785 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Autonomic nervous system imbalance, Headache, Heart rate increased, Hypoaesthesia, Hypoaesthesia oral, Neuralgia, Neurological symptom, Pain in extremity, Spinal pain, Temperature regulation disorder
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Immune-mediated/autoimmune 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: Fish oil, Vit C, Elderberry
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Neurological symptoms including autonomic dysfunction with difficulty regulating temperature and elevated HR followed by nerve pain into hands and feet, extreme joint pain, headache and spine pain, and then numbness of the hands and lips. Began about 10 hours post vaccine and subsided except headache and joint pain within 16 hours


VAERS ID: 1674789 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Feeling cold, Headache, Hypoaesthesia, Myalgia, Nausea, Paraesthesia, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions: Type 1 Diabetes (Lada) Hypothyroidism
Allergies: Amoxicillin, Penicillin, shitake mushrooms
Diagnostic Lab Data:
CDC Split Type:

Write-up: 3 separate events of freezing with severe chills, rigor/uncontrollable shaking (9/3 8:30pm-9:15pm; 9/4 3:48am-5:57am; 9/4 10:11am-11:44am) Numbness and tingling in fingertips (9/3 8:45pm-9:15pm) Muscle aches (started 9/3 at 9:30pm and during shakes) High fever (started 9/3 at 9:30pm until 9/4 at 5:12pm; highest 103.8 12:18pm on 9/4) Moderate headache (began 9/4 at 3:48am, still ongoing) Moderate nausea (began 9/4 at 10:11am, and still ongoing) Took Ibuprofen 800mg 9/3 at 10:30pm Took Tylenol extra strength 1000mg at 5:16am and at 10:43am Took Ibuprofen 800 mg at 2:12pm Took Tylenol 1000mg at 5:12pm Took Ibuprofen 800mg at 8:12pm


VAERS ID: 1674794 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Gait inability, Hypersensitivity, Seizure, Sleep disorder
SMQs:, Angioedema (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Minipress, Jardiance, Victoza, Zanaflex, Metformin, Basaglar, Lisinopril, Keppra, Lipitor
Current Illness: n/a
Preexisting Conditions: Epilepsy, diabetes, hypertension, hyperlipidemia
Allergies: Tramadol
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Pt. reported waking up at 3 am the next morning after vaccination and being very dizzy and weak and unable to have the strength to walk. Pt. went to ER and they told her she was having a reaction to the vaccine and sent her home and said should be better in a day. Pt. called the pharmacy the next afternoon and said her legs were still very weak and that she had also had 2 seizures earlier (pt. has a prior history of epilepsy and is being treated).


VAERS ID: 1674796 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Wrong 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: penicillen, sulfa, tree nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: my daughter went for her second dose of HPV shot and was given a second dose of the covid vaccine. iI received a phone call that she was administered the wrong vaccine. The nurse practitioner didnt even ask for her covid vaccine card.


VAERS ID: 1674799 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dizziness, Dysphagia, Injection site pain, Lip swelling, Nausea, Paraesthesia oral, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Did not seek treatment as I do not have insurance. If the swelling of the tongue had gotten any worse, I would have called emergency services.
CDC Split Type:

Write-up: After shot: +0 minutes: Felt completely fine and normal +5 minutes: Dizziness, nausea, feeling of dread +6 minutes: Tongue began to swell and tingle +10 minutes: Lip tingling, some difficulty swallowing +30 minutes: Severe nausea, increased difficulty swallowing, lips swelling, swelling around cheeks and jaw +1 hour: Took Benedryl for symptoms +3 hours: Swelling mostly receded, most initial symptoms completely gone +4 hours - present: Chills, severe soreness in arm injection sight


VAERS ID: 1674821 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Paraesthesia oral, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Minimal tongue and lip paresthesia and swelling. Self-administered 25mg benadryl, 20mg pepcid and 8mg Decadron with improvement in 4-6 hours. Symptoms resolved completely upon waking up next morning.


VAERS ID: 1674824 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-27
Onset:2021-09-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Facial paralysis, Hyperacusis, Skin tightness
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (narrow)

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

Write-up: Patient is a 19-year-old, who reports to urgent care with complaint of left-sided facial paralysis. Reports he feels like his face is tight. Noticed yesterday that he could not puff out his cheek on the left side and his left ear was sensitive to sound. Reports that he received his first Covid vaccination 7 days ago. Denies any stressors, illness, sick contacts.


VAERS ID: 1674833 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Blood pressure increased, Dizziness, Dyspnoea, Malaise
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: About 5-10 minutes after giving Patient her second Moderna vaccine, her husband reported to the drop-off window to let us know she was not feeling well. I immediately went out to check on her and to ask her how she was feeling exactly. She stated she did not feel well; she was dizzy and lightheaded, a little sick to her stomach, she was fanning herself like she was hot, and stated she felt like passing out. I proceeded to ask her if she was having any trouble breathing or swelling of the throat/tongue and she stated no. I also observed her while we were talking and did not notice any respiratory issues or facial swelling, but I could tell she was anxious. Her husband asked if I could lay her down in the immunization room, but I didn''t want to move her just yet in case she were to pass out and fall upon standing. She stated that she needed some water so her husband went to get her some after I got the BP monitor out of the immunization room. I checked her BP and it was 150/63 with PR of 94, which was elevated for her according to her and her husband, and she confirmed she was not on any blood pressure medicines. While I was checking her blood pressure, she kept repeating that she really was not feeling well, so I told her we would call EMTs and had my tech call while I stayed with her. Then she said she really wanted to lay down away from the people in the waiting room to see if that helped, so I went to ask my store manager if she could lay in one of the offices or conference room where there was more space. I went right back to the patient at that time and then she stated that she felt like she was starting to have a little trouble breathing. My manager had followed me back to the patient to guide them to her office. She still wanted to go lay down though, so her husband helped her to the office with my manager while I went into the immunization room to grab the epipen, diphenhydramine. supplies, and protocol to bring to the office. When I got to the office with the supplies, she was already laying down for about a minute and stated that she was already feeling better and actually did not feel like she was having trouble breathing. I hung around for a minute and she said she was still feeling a little better, so my manager wanted me to go ahead and give her and her husband a little space. She kept an eye on them while I went to check on things in the pharmacy. I took a few minutes to take care of a few things needed in the pharmacy and then went back to check on the patient. The paramedics had arrived and were already assessing her, so I went back to the pharmacy again for a few minutes. When I went back to my manager, she said the paramedics think the patient just had an anxiety attack and that she was doing much better, so I went back to the pharmacy to stay this time, and shortly after, my manager came by to let me know the patient was okay and her and her husband were able to get up and walk out on their own.


VAERS ID: 1674843 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest discomfort, Chest pain, Injection site pain, Neck pain, Pain in extremity, Pain in jaw, Painful respiration
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Sudden onset pain in injected arm into shoulder, chest, back, neck & jaw, chest pain and tightness, exacerbated by laying down and deep breathing. Relived only by nitroglycerin.


VAERS ID: 1674847 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-26
Onset:2021-09-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Appendicitis, Computerised tomogram
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen prn
Current Illness: Arthritis
Preexisting Conditions: Arthritis
Allergies: Hydrocodone
Diagnostic Lab Data: 8/4 ct scan
CDC Split Type:

Write-up: Acute appendicitis


VAERS ID: 1674849 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (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: Adderall
Current Illness: Cold or sinus infection two weeks prior
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: About one hour after vaccine was administered, my left forearm and left hand started to tingle. My hand then felt numb or as if it were ?asleep.? I called the pharmacy and was advised to take Benadryl. I took 25 mg of Benadryl around 10:15. Around 10:20, my throat began to feel ?small? or as if it were getting tight or closing. Around 10:40, my throat felt normal but my arm and hand was still tingly and numb feeling. Today, my hand has felt like it is ?asleep? all day.


VAERS ID: 1674877 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-19
Onset:2021-09-03
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Oral disorder
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Keppra, Synthroid, Omeprazole
Current Illness: none
Preexisting Conditions: Epilepsy, hypothroidism, hiatal hernia
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Oral lesions


VAERS ID: 1674892 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Electrocardiogram normal, Fibrin D dimer normal, Troponin I increased, Vomiting
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data: elevated troponin I level with normal d-dimer, chest x-ray and EKG
CDC Split Type:

Write-up: chest pain, vomiting


VAERS ID: 1674921 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Hyperhidrosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Vomiting & extreme fatigue - 9:30p on 9/3/2021 Severe chills/profuse sweating/severe joint pain - 5am on 9/4/2021 until 10pm on 9/4


VAERS ID: 1674945 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Headache, Injection site pain, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: High Fever, body aches, nausea, headache, acute pain surrounding injection site


VAERS ID: 1674953 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: PCN and Coconut
Diagnostic Lab Data: BP: 156/95 , HR: 87 , SP Oz: 100%
CDC Split Type:

Write-up: Patient stated that she had a scratchy throat, breathing problem . Patient stated scratchiness getting better. Advised to stop on the way home to take Benadryl.


VAERS ID: 1674955 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Decreased appetite, Influenza like illness, Lethargy, Mobility decreased, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Within 6 hours, fever started to increase to just under 103...confined to bed rest 9/4/21 and did not eat since Friday at noon...fever finally down to 99.8 on 9/5/21 which is 48 hours after injection. Feels like I have the flu...no cough or chest congestion...weak, lethargic, heart racing started 6 hours after but has subsided now.


VAERS ID: 1674959 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-27
Onset:2021-09-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Erythema, Fatigue, Induration, Injection site bruising, Injection site warmth, Limb discomfort, Myalgia, Pain in extremity, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles, Arm soreness and red, March 2020
Other Medications: Topiramate, Tylenol, Advil, Anastrozole, emgality, ubrelvy, D3
Current Illness: Carpal Tunnel Release surgery, Low Back Stenosis
Preexisting Conditions: Elevated CPR, Meningioma Tumor head, Migraine Headaches, Cervical and Lumbar disc disease, Sleep Apnea, Obesity
Allergies: Percocet
Diagnostic Lab Data: currently none
CDC Split Type:

Write-up: Upper arm and shoulder were sore from hours after the injection. Seemed muscular. The muscular soreness seemed to get better over the next 7 days but on Friday night I noticed that the injection site felt like a bruise and it was getting warm, also my arm was tight, like from swelling to move. By Saturday morning, I put ice on my arm and took 3 Advil, 600mg . By Saturday night the redness and hard area over the upper part of my arm developed. Also am very tired. During the night the swelling of my arm increased, took 600mg of Advil again. Redness is about 3 inch in diameter, watching to see if it increases over the next few days.


VAERS ID: 1674961 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Headache, Pain
SMQs:, Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil, trazadone, Coreg, lisinopril, hydrocodone, Xanax, nexium, tegretol
Current Illness: Heart disease including mitral valve replacement, Fibromyalgia, hernia
Preexisting Conditions: See above
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, body aches , no energy


VAERS ID: 1674965 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-01
Onset:2021-09-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Lymph node pain, Lymphadenopathy, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes 1
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen and painful lymph nodes under left arm 4 days Severe body muscle pain 12 hours Fatigue 3 days Chills 12 hours


VAERS ID: 1674976 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

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

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

Write-up: the vaccine was given at 11 am at 1am pain in joints severve chills


VAERS ID: 1674985 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Chills, Headache, Pain, Pollakiuria, Throat irritation
SMQs:, Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, D, and B12. Imitrex as needed.
Current Illness:
Preexisting Conditions: Migraine headaches.
Allergies: Mantoux TB Test.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chills, temperature of 101, excessive urination (every 45 minutes -1 hour), constant, ever headache, scratchy throat, weakness, sporadic pain in lower right side; all afore-mentioned symptoms lasting for approximately 12 hours, except temperature of 99.7 carried over through the subsequent several hours.


VAERS ID: 1675018 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD 8448 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Gait inability, Muscle spasms, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonazepam 1/2mg Risedronate Sodium Tablets 35mg
Current Illness: N/A
Preexisting Conditions: Anxiety Osteoporosis
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe leg cramp from left toes up to hip at 11:00 am lasting approximately 3 minutes. Relaxed again to wake to another severe cramp on right side leg that lasted approximately 1 1/2 minute. Made it to bathroom where I could not even sit. Still pain in calf area today and unable to walk steps normally. I am finally able to move foot and toes on both legs today.


VAERS ID: 1675043 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FIRST: FA6780A, / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram abnormal, Headache, Myalgia, Nausea, Platelet count normal, Vomiting, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aripiprazole, cetirizine, claritin, venlafaxine, buspirone, oxycarbazepine
Current Illness: N/A
Preexisting Conditions: Autism/ADHD Anxiety
Allergies: Sulfa, cephalosporins
Diagnostic Lab Data: EKG: HR 101, sinus rhythm L axis deviation WBC 11, normal, plts: 245 Have asked for Respiratory pathogen panel, EBV/CMV/HHV-6 serum PCR COVID nucleocapsid metabolic panel ECHO
CDC Split Type:

Write-up: Nausea, vomiting, myalgia, HA (after second Pfizer dose, dose given 9/2, felt symptoms 9/3) 9/4- chest pain (4-6hrs)


VAERS ID: 1675057 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Axillary pain, Flushing, Glossodynia, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Enskyce birth control pill
Current Illness: None
Preexisting Conditions: None
Allergies: Not applicable
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Day after having the shot I developed mouth sores, 1 on the right side and bottom of my tongue, and 1 on the bottom of my mouth under my tongue all on the right side, they hurt when I eat and talk mostly. My left armpit has a tender and sore spot towards the back of my pit. Other symptom I am experiencing is flushed face mainly my upper cheeks are redder in the mornings. These 3 symptoms I have been experiencing for 3 days now. I had the shot on a Thursday and it is now Sunday.


VAERS ID: 1675073 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Extra dose administered, Hyperhidrosis, Migraine, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna, moderate side effects after 2nd dose
Other Medications: Stribild
Current Illness:
Preexisting Conditions: HIV-undetectable
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever, migraine, dizziness, lightheaded, chills and sweats. Much worse than the 2nd shot. This was my booster


VAERS ID: 1675082 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Hyperventilation
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Flushed / Sweating-Mild, Systemic: Hyperventilation-Mild


VAERS ID: 1675088 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Headache, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin Sertraline 50 mg Bupropion 100 mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muscle/join paint Fever Chills Headache Vomiting


VAERS ID: 1675102 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Erythema, Fatigue, Paraesthesia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 9/3/21 Fever 100.9 F. tingling of the extremites, extreme tireness 9/4/21 Joint pain, few red spot on the body (resolved within 4 hours) 9/5/21 Rash on one side of the upper body, tingling sensation on extremities


VAERS ID: 1675106 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Injection site pain, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Second Pfizer dose, 2/28/21, rash on arm for several days
Other Medications: Xarelto, fish oil, nefedipine, doxycycline, topiramate, calcium w/vitamin D, CoQ10
Current Illness:
Preexisting Conditions: Crohn''s first, psoriatic arthritis, undifferentiated connective tissue disease,
Allergies: Erythromycin, sulfa, levafloxacin, cephalexin, tetanus vaccines, cosentyx
Diagnostic Lab Data: None
CDC Split Type:

Write-up: $g Day one 9 /3 - sore arm at injection site approximately 6 hours after injection $g Day one 9/3 - watery diarrhea, two bouts, approximately 10 hours after injection $g Day two 9/4 - general fatigue and body aches, no arm pain or diarrhea $g Day three 9/5 - light rash on chest, some fatigue and body aches, no arm pain or diarrhea


VAERS ID: 1675130 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 3 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Patient requested Moderna; Previously had Pfizer, told Pfizer would be dose but vaccinator delivered Moderna to patient. No adverse event.


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