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From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 28 out of 5,069

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VAERS ID: 1467300 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Chills, Fatigue, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen, women?s daily vitamin, vitamin d3
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None to date
CDC Split Type:

Write-up: Soreness in left arm, extreme fatigue, chills, fever, full body muscle aches, weakness, stomach uncomfortableness


VAERS ID: 1467329 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary mass, Axillary pain, Breast swelling, Lymphadenopathy
SMQs:, Angioedema (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: NSAIDS; ibuprophen, Advil
Diagnostic Lab Data:
CDC Split Type:

Write-up: swollen lymph nodes (lymphadenopathy) in left arm pit (arm of injection), swollen breast area,, lump in arm pit; sore


VAERS ID: 1467739 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-26
Onset:2021-07-12
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal wall mass, Anticoagulant therapy, Antiplatelet therapy, Arteriogram carotid normal, Atelectasis, Cardiomegaly, Catheterisation cardiac abnormal, Chest X-ray abnormal, Chest discomfort, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis, Computerised tomogram thorax abnormal, Coronary artery disease, Echocardiogram, Ejection fraction normal, Electrocardiogram ST segment elevation, Facial discomfort, Hepatic steatosis, Hepatomegaly, Hyperdynamic left ventricle, Infusion, Left ventricular hypertrophy, Lung infiltration, Magnetic resonance imaging heart, Musculoskeletal discomfort, Myocarditis, Pericardial effusion, Pulmonary fibrosis, Soft tissue mass, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen (TYLENOL) 325 mg Oral Tab Biotin 10 mg Oral Tab clonazePAM (KLONOPIN) 0.5 mg Oral Tab Gabapentin (NEURONTIN) 300 mg Oral Cap Glucosamine Sul-Chondroitn-MSM (MEDI-FLEXX) 500-400-200 mg Oral Tab (? formulation) Ibuprofen (MOTRIN
Current Illness: R knee osteoarthritis flare
Preexisting Conditions: ? VARICOSE VEINS OF BILAT LEGS ? ARTHRITIS OF RIGHT KNEE ? TOBACCO USER ? PREDIABETES ? HYPOTHYROIDISM ? MERALGIA PARESTHETICA. ? VITAMIN D DEFICIENCY ? SEVERE OBESITY EQUIVALENT, BMI 39-39.9, ADULT W CO-MORBIDITY ? ENDOMETRIOSIS ? HX OF TOTAL HYSTERECTOMY W HX OF BENIGN DISEASE ? POISONING BY ANALGESIC OR ANTIPYRETIC. ? DEPRESSION, UNSPECIFIED ? PROLONGED FEVERS Onset early/mid July 2008. ? CHRONIC PAIN ? LOW BACK PAIN ? LUMBOSACRAL SPONDYLOSIS WO MYELOPATHY ? PANIC DISORDER ? VITAMIN B12 DEFICIENCY ? HX OF childhood physical and SEXUAL ABUSE ? RESTLESS LEGS. Administrative Coding Change ? FACET SYNDROME. ? SPINAL STENOSIS ? INSOMNIA chronic ? SEASONAL ALLERGIES ? ANXIETY DISORDER
Allergies: ampicillin; cyclobenzaprine hcl; erythromycin base; hydromorphone hydrochloride.; morphine sulfate; penicillin v potassium; sertraline hcl; and sulfa (sulfonamide antibiotics).
Diagnostic Lab Data: TROP serial labs: 10.80* (7/13/21, 0700) 8.10* (7/12/21, 2100) 3.13* (7/12/21, 1500 0.06* (7/12/21, 0730) OR Procedure(s) (LRB): CORONARY ANGIOGRAPHY (N/A) XR CHEST PA AND LAT Result Date: 7/12/2021 EXAM: XR CHEST PA AND LAT EXAM DATE AND TIME: 7/12/2021 11:25 AM Stable examination without radiographic evidence of an acute intrathoracic process. Electronically signed by MD. 7/12/2021 11:56 AM XR CHEST 1 VIEW Result Date: 7/13/2021 FINDINGS: Basilar lung aeration has improved. Residual left infrahilar and bibasilar scarring. No pulmonary edema or consolidation. Heart size mildly enlarged. Stable mediastinum. No pneumothorax. No pleural effusion. Electronically signed by MD. 7/13/2021 9:34 AM TRANSTHORACIC ECHO REAL TIME W 2D IMAGE, SPECTRAL AND COLOR FLOW DOPPLER COMPLETE Result Date: 7/12/2021 Summary The left ventricular size is normal. There is normal left ventricular wall thickness. The left ventricular systolic function is hyperdynamic (visually estimated EF 70% +/- 5%). There are no segmental wall motion abnormalities noted. Normal right ventricular size and systolic function. There is no hemodynamically significant valvular disease. Trivial pericardial effusion. No prior studies for comparison. CTA NECK CHEST ABD AND PELVIS WO/W CONTRAST Result Date: 7/12/2021 1. No aortic dissection. 2. LVH. 3. No pericardial effusion. 4. Small infiltrate, left upper lobe. 5. Unexplained small soft tissue mass, under the anterior abdominal wall. Incidental finding. 6. Enlarged fatty liver. Electronically signed by MD. 7/12/2021 8:00 PM CARDIAC CATHETERIZATION ORDERABLE, CARDIOVASCULAR Result Date: 7/12/2021 1. Minimal epicardial CAD 2. Hypertension Recommendations: - Radial Hemoband for 2 hours
CDC Split Type:

Write-up: Suspected myopericarditis. 55 yrs old female with history of tobacco use disorder, obesity, who presented with acute-onset chest discomfort radiating to her bilateral jaw and upper back. EMS noted STE on ECG. STEMI alerted was activated. Patient was taken for emergent cardiac catheterization, which disclosed essentially normal coronary vessels. It was felt unlikely she had coronary vasospasm per interventional cardiology. Troponin continued to rise, to peak 10.8 prior to discharge. She underwent the above-noted CTA to rule out aortopathy, which was reassuring. TTE with normal LV size and function, hyperdynamic systolic function, no wall motion abnormalities, normal RV size and function, and with trivial pericardial effusion and no valvular disease. She was initially started on dual antiplatelet therapy post catheterization as well as UFH drip, though this was subsequently discontinued given increased clinical suspicion for myocarditis. She was started on colchicine and NSAIDs, with marked improvement to her chest discomfort. Given this, cardiology felt cMR not clearly indicated to assist with diagnosis. Per cardiology, plan to continue colchicine for 3 month course, plan to use only PRN NSAIDs rather than scheduled dosing.


VAERS ID: 1467992 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dizziness, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: I have no laboratory results related to the adverse events
CDC Split Type:

Write-up: On the first day, 07/12/2021, I began to get chest pains around 2 pm. The today, 07/13/2021, the chest pains got worse followed by sudden dizziness and rapid heart rate.


VAERS ID: 1468375 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-08
Onset:2021-07-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Complex regional pain syndrome, Dyspnoea, Hypoaesthesia, Injection site hypoaesthesia, Injection site paraesthesia, Loss of personal independence in daily activities, Paraesthesia, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Some numbness / tingling in left arm and dull headache lasting several weeks
Other Medications: Daily Supplements: Biotics Research brand: Fe-Zyme, Intenzyme Forte, Li-Zyme. Standard Process brand: Neurotrophin PMG, Linum B6 (x2), Rehmannia Complex, Zinc Chelate. Nutri-West brand: Adreno-Lyph 80.
Current Illness: Complex regional pain syndrome
Preexisting Conditions: Complex regional pain syndrome (diagnosed 11/2017)
Allergies: Penicillin, gabapentin
Diagnostic Lab Data: N/A. Have been resting at home but will go to urgent care or PCP tomorrow if chest pain hasn?t subsided.
CDC Split Type:

Write-up: Symptoms began in the afternoon on Monday, July 12 around 2:00-3:00pm. I began experiencing numbness and tingling in right arm all the way from injection site through my right hand. Numbness has been strong enough at times over the last day or two to disrupt my daily routine. I began having a sharp pain in my chest that hasn?t subsided since the onset. This caused difficulty sleeping and the pain has been strong enough to be a distraction throughout the day. I am not experiencing any shortness of breath, but there is a strong tightness in chest. Something to note: I also experienced a similar numbness in left arm after first vaccine (06/17/21 EW0181) which I assumed was related to my Complex Regional Pain Syndrome (CRPS). I had a full headache for a couple weeks following this dose but no chest pain.


VAERS ID: 1469905 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oropharyngeal pain, Painful respiration, Pulmonary pain, Throat irritation
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I expected fever and tiredness but no where online or in person has anyone said anything about throat and lung pain. Ever since I woke up the next morning after receiving the vaccine my throat burns and my lungs ache with each breath I take. Hot beverages stop it for a short amount of time and ibuprofen (though it is child ibuprofen but I am not good at taking pills) worked at first and hasn''t really since the first time. In theory my brother has also been experiencing this sort of pain but all he is saying in regards to it is that his chest hurts.


VAERS ID: 1469912 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild


VAERS ID: 1469914 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 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? 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: Error: Booster Given Too Early-


VAERS ID: 1469938 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fall, Fatigue, Lethargy
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Weakness-Severe, Additional Details: pt fell to th floor 10 minutes afterward,called paramedics and was transported to ER


VAERS ID: 1470136 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-10
Onset:2021-07-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: Two days after receiving the first Pfizer Covid Vaccine, I am experiencing a rapid heart rate and chest pain. I conducted some research on the topic and learned that there is a link between the vaccine and heart-related issues, such as inflammation. What does the CDC recommend at this point? Will this issue resolve itself or should I go to the hospital?


VAERS ID: 1470154 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-05-31
Onset:2021-07-12
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mass
SMQs:

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

Write-up: Lump on back of head left side


VAERS ID: 1470161 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metformin, astrovatin, farxiga, multivitamin, fish oil, lisinopril
Current Illness: None
Preexisting Conditions: Diabetes, type 2
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received shot in right arm. Woke up with sharp pain and tingling in right finger tips. Pain and tingling slowly went away over next days.


VAERS ID: 1470167 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-02
Onset:2021-07-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Muscle spasms
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

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

Write-up: Muscle spasms, numbness in pinky finger, and severe headaches.


VAERS ID: 1470169 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blepharospasm, Dysgeusia, Throat irritation
SMQs:, Taste and smell disorders (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (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: diclofenac, ketorolac, KCL, dipyrone
Diagnostic Lab Data: hydration and PO diphenhydramine 50 mg
CDC Split Type:

Write-up: patient experienced itching in the throat, metallic taste in mouth and bilateral eye twitching


VAERS ID: 1470173 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Myalgia, Neck pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), 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: Levothyroxin 50 mcg Fexofenadine 180 mg
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: PEG-80 and higher molecular weight Egg white Sunflower seeds/oil
Diagnostic Lab Data:
CDC Split Type:

Write-up: Low-grade fever (99.9 F - 100.4 F) Extreme fatigue Muscle aches Headache Neck pain Soreness at injection site


VAERS ID: 1470195 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-27
Onset:2021-07-12
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

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

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

Write-up: SARS COV 2 RNA(COVID 19), QUALITATIVE NAAT test performed on 07/12/2021 at 12:00. Test came back positive. Case investigation interview with patient has not been conducted as of the time of this note.


VAERS ID: 1470220 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Pain
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Lump above left collarbone. Size about 1.5-2? in diameter. Size reduced the following day on 7/13/21. Maybe a swollen lymph node? Slight pain during swim practice when rotating arm.


VAERS ID: 1470288 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-09
Onset:2021-07-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Right sided lymph node swelling (submental and submandibular), with soreness at swollen sites.


VAERS ID: 1470292 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

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

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

Write-up: pain of 3 - 4 on the 1 - 10 scale in the right deltoid muscle where the shot was given.


VAERS ID: 1470304 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-15
Onset:2021-07-12
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EEW0179 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

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

Write-up: Patient had a miscarriage.


VAERS ID: 1470346 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-13
Onset:2021-07-12
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Dysphagia, Guillain-Barre syndrome, Headache, Hypoaesthesia, Immunoglobulin therapy, Intensive care, Lumbar puncture, Magnetic resonance imaging, Movement disorder, Paraesthesia, Spinal laminectomy, Spinal operation, X-ray
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, atorvastatin, benazepril, duloxetine, omeprazole
Current Illness: Patient had back surgery between receiving vaccine and developing reaction.
Preexisting Conditions: Hypertension Hyperlipidemia
Allergies: NKA
Diagnostic Lab Data: Patient has had CT, MRI, and X-ray. Lumbar puncture. (7/13/21)
CDC Split Type:

Write-up: Pt developed tingling in toes and fingers that have progressed to numbness and climbed up extremities to now include above the wrist down, and patient is now unable to ambulate. Progression has been over three days. Providers have diagnosed Guillain-Barre. Patient received Pfizer Covid vaccine on 5/6/21 and 5/27/21. Additionally, patient has underwent lumbar laminectomy in June 2021. Pt also complained of trouble swallowing and headache on admission. Pt received first dose of IVIG last night, is due to receive second dose tonight. Pt was transferred to ICU level of care over night. He is currently still admitted, there is discussion of transfer to another hospital with higher level neurology services at this time. If he remains stable he will stay here.


VAERS ID: 1470348 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-01-23
Onset:2021-07-12
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Milk of Magnesia Suspension 400 MG/5ML (Magnesium Hydroxide) 30ml QD as needed amLODIPine Besylate Tablet 10 MG 1 tablet by mouth one time a day Brimonidine Tartrate-Timolol Solution 0.2-0.5 % 1 drop in both eyes every 12 hours Vitamin
Current Illness: None.
Preexisting Conditions: HALLUCINATIONS, UNSPECIFIED DELUSIONAL DISORDERS COMPLETE TRAUMATIC AMPUTATION AT LEVEL BETWEEN KNEE AND ANKLE, UNSPECIFIED LOWER LEG CHRONIC PAIN SYNDROME MAJOR DEPRESSIVE DISORDER, RECURRENT, UNSPECIFIED INSOMNIA, UNSPECIFIED ACQUIRED ABSENCE OF LEFT LEG BELOW KNEE ANEMIA, UNSPECIFIED ESSENTIAL (PRIMARY) HYPERTENSION PSYCHOTIC DISORDER WITH DELUSIONS DUE TO KNOWN PHYSIOLOGICAL CONDITION PRIMARY OPEN-ANGLE GLAUCOMA, BILATERAL, STAGE UNSPECIFIED ONYCHOGRYPHOSIS TINEA UNGUIUM VITAMIN D DEFICIENCY, UNSPECIFIED PERSONAL HISTORY OF COVID-19 FEEDING DIFFICULTIES UNSPECIFIED DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE
Allergies: No known allergies.
Diagnostic Lab Data: COVID-19 positive on 7-12-2021.
CDC Split Type:

Write-up: Tested positive for COVID-19 after Receiving full 2 doses of COVID-19 vaccines on 1/3/2021 and 1/23/2021. He had tested positive for COVID-19 previously on 12/3/2020. Both COVID tests were PCR tests.


VAERS ID: 1470361 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0198 / 2 LA / IM

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

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

Write-up: Patient has had severe headache with dizziness for the past 36 hours. She has tried ibuprofen and states it is not helping with the symptoms. Patient did have fever for the first 24 hours. It has resolved. She has some fatigue and muscle soreness as well 38 hours post-injection. Patient is going to try Acetaminophen to help with symptoms as well.


VAERS ID: 1470408 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-06
Onset:2021-07-12
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EK5730 / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EK9231 / 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: PCR positive
CDC Split Type:

Write-up: Became symptomatic 07/12 and PCR positive.


VAERS ID: 1470483 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Hyperhidrosis, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Motrin
Current Illness: none
Preexisting Conditions: none
Allergies: Banana, avocado, kiwi
Diagnostic Lab Data: only the vax caused this
CDC Split Type:

Write-up: fever 100-101, vomiting, sweating, headache


VAERS ID: 1470492 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: After about 5 minutes after getting her Pfizer dose, she was pale. She vomited and was not able to see. EMS called and when they came they checked her blood pressure which was 74/49. EMS stayed with patient for another 20 minutes until the patient became better and was okay to return home with her mom.


VAERS ID: 1470529 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Seizure, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Tic disorder
Allergies: None
Diagnostic Lab Data: 0
CDC Split Type:

Write-up: Syncope episode/shaking/seizure low blood pressure transported via ambulance to ER


VAERS ID: 1470540 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram T wave inversion, Pain, Pyrexia, Swelling, Troponin normal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (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: 15 y/o M with hx of autism presents to the ED with chest pain. Pt received 2nd dose of COVID vaccine on Monday. Pt had body aches onset Monday and L sided chest pain onset last night. Per mom, swelling on L side of chest. Pt given Tylenol. Pt denies SOB, cough, diarrhea, emesis. Pt has 38.2C fever onset this morning. No PMH. No sick contacts. NKA. Vaccines UTD. No medications taken on a daily basis. EKG Findings Time 07/14/21 08:36:00, Rate 101, Normal sinus rhythm, T wave inversion in Inferior leads. Case d/w cardiology. Normal troponin level. Unlikely myocarditis induced by COVID vaccine. Recommends mom to follow up with Pediatrician. If pain persists next week can follow up with Cardiology or have Pediatrician do 2nd troponin test done outpatient.


VAERS ID: 1470649 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-09
Onset:2021-07-12
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Headache, Monoclonal antibody unconjugated therapy, Myalgia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Received Pfizer vaccines on 1/20/21, 2/9/21. Tested positive for COVID-19 by PCR on 7/12/21, symptom onset 7/8/21 with new cough, fatigue, H/A, mylagia; known exposure to COVID, received monoclonal Antibody therapy on 7/14/21.


VAERS ID: 1470664 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-03-01
Onset:2021-07-12
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Fatigue, Muscle spasms, Muscular weakness, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)

Life Threatening? Yes
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: blood pressure meds, allergy meds
Current Illness:
Preexisting Conditions: arthritis chronic pain from a fall at age 35
Allergies: peppers
Diagnostic Lab Data: CT Scan, bloodwork and urine test
CDC Split Type:

Write-up: first shot gave her lots of energy 2nd shot - arm tiredness, muscle cramps and fatique


VAERS ID: 1470668 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-08
Onset:2021-07-12
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN-NOT IN / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN-NOT IN / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, COVID-19, Cough, Dyspnoea, Exposure to SARS-CoV-2, Headache, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: Received Pfizer vaccines on 1/18/21, 2/8/21; tested positive for COVID-19 by PCR on 7/12/21; known exposure to COVID, beginning 7/6/21 had New sore throat, New cough, New shortness of breath, New headache, New loss of smell; received monoclonal antibodies on 7/14/21.


VAERS ID: 1470762 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Confusional state, Dizziness, Dyspnoea, Fatigue, Headache, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 88mcg Multivitamin Fish Oil Probiotic
Current Illness: None
Preexisting Conditions: Psuedotumor cerebri Hypothyroidism Pulmonary hypertension
Allergies: Penicillin, Keflex, Celebrex, tetracyclines
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest tightness, shortness of breath, extreme fatigue, dizziness, light head, headache, nausea, and confusion


VAERS ID: 1470810 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-04
Onset:2021-07-12
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Lymphadenopathy, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81, calcium, fish oil, flax seed oil, vitamin b complex, vitamin d3
Current Illness:
Preexisting Conditions: multiple sclerosis, arthritis, ulcerative colitis
Allergies: sulfasalazine, tetracycline
Diagnostic Lab Data: On 7/14/21 COVID-19 FIA (SARS-CoV Antigen) test was completed via nasal swab. Test was positive
CDC Split Type:

Write-up: on 7/12/21 patient noticed swollen gland in right submandibular region, with mild fever off 100F last night. Patient noticed an increase in the size of gland overnight.


VAERS ID: 1470825 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-08
Onset:2021-07-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / SYR

Administered by: Private       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? Yes
Hospitalized? No
Previous Vaccinations: FluAB. numerous dates since vaccine availability
Other Medications: zyrtec 1hr before vaccination
Current Illness: na
Preexisting Conditions: graves disease. allergies. high blood pressure. acid reflex
Allergies: penicillin, augmenten, sulphates, melaluca
Diagnostic Lab Data: only triage and vitals were needed
CDC Split Type:

Write-up: started with rash on both arms. rash travelled quickly from neck to toes. went to the ER. DR confirmed reaction from vaccination. No treatment was done after confirming airway was clear. Advised not to administer steroids to allow the vaccination benefits to take place. DR advised- do not take 2nd dose. Return if rash worsens or airway becomes affected.


VAERS ID: 1470846 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 4 LA / IM

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

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

Write-up: Patient participated in a COVID vaccine clinic at his workplace. Received a COVID vaccine and was discovered through the state health tracking that it was his 4th dose.


VAERS ID: 1470858 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient participated in a COVID vaccine clinic at her workplace. She received the vaccine and upon further review it was discovered the patient''s first dose was only 13 days prior.


VAERS ID: 1471033 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 1 RA / IM

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

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

Write-up: Bump on the arm


VAERS ID: 1471065 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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:
Other Medications: Fluoxetine
Current Illness:
Preexisting Conditions: Anxiety
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted shortly after receiving the vaccine. He was only out for a short moment and then started talking again. He stated he felt woozy and then after a cold compress on his neck and some water he felt better. He also said that he hadn''t eaten anything yet.


VAERS ID: 1471280 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood chloride normal, Blood glucose normal, Blood potassium normal, Blood sodium decreased, Blood urea normal, C-reactive protein increased, Carbon dioxide increased, Chest discomfort, Chest pain, Eosinophil percentage, Full blood count, Haematocrit normal, Haemoglobin normal, Lymphocyte percentage increased, Malaise, Mean cell volume normal, Monocyte percentage increased, Myocarditis, Nausea, Neutrophil percentage decreased, Platelet count normal, Troponin increased, Vomiting, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Haematopoietic leukopenia (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Autism Spectrum disorder and Speech delay
Allergies: nka
Diagnostic Lab Data: 07/13/21 2313 NA 135 K 3.5 CO2 30 CL 97* BUN 11 CR 0.46 RBS 106 CBC Recent Labs 07/13/21 1554 WBC 5.8 HGB 14.8 HCT 41.2 PLT 273 MCV 81 NEUT 46 LYMPH 41 MONO 11 EOS 1 Cardiac Recent Labs 07/14/21 1130 07/14/21 0543 07/13/21 2313 TROP 8.20* 7.57* 11.05* Results as of 7/14/2021 17:40 7/13/2021 15:54 CRP, SER QL: 1.0 (H) 7/13/2021 23:13 CRP, SER QL: 0.9 7/14/2021 11:30 CRP, SER QL: 0.6
CDC Split Type:

Write-up: 12 Y 4 M old male with a history of chest pain that started two days ago on Monday. On 7/11 night, he didn''t feel well felt nauseous. He was able to sleep but had chest pain the following morning that improved after he vomited. The chest pain is midsternal and feels pressure-like. It lasted a few hours. He swam on 7/12 without problems (at a swim club) for an hour. He had his second dose of COVID-19 vaccine on Saturday 7/10/21. There has not been any fevers. Elevated troponin and CRP with recent COVID-19 vaccine, suspicious for post-vaccine myocarditis. He is hemodynamically stable with normal vitals and no evidence of ventricular ectopy or depressed left ventricular function. His troponin peaked at 11.05 and trended down, but his most recent value is slightly up at 8.2 from 7.6. Recommended continuing to trend the troponins for now (if they show a downward trend then twice daily is adequate, unless he develops chest pain). At this time, IVIG is held unless he becomes unstable or the troponins trend upward .


VAERS ID: 1471475 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle tightness, Pain
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

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

Write-up: Patient said a couple hours after the injection she started noticing some numbness in her left hand. The next day she also noticed that she was having what she described as tightness, throbbing, pain and numbness in her left leg as well. Patient said she has tried taking some aspirin and it did not relieve the pain. Told her to try taking some Tylenol to help with the pain and to monitor her symptoms closely and to seek medical attention if her symptoms do not start to improve by next morning or if they start to worsen.


VAERS ID: 1471667 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

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

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

Write-up: The Janssen vaccine was administered about an hour after expiration. A patient was administered with Janssen vaccine at 1:50pm and when they checked the Vaccine tracking sheet and Janssen vaccine Lot# 1808980 was first puncture on 07/12/2021 at 11:00 am (expiration time 2 hours in room temperature) 01:00 pm. around 2pm then they realized the vaccine was expired but patent was gone already. I called patient and I have been calling but patient never answer the phone, I leave a voicemail with a phone number for a call back, patient is not aware that he received an expired vaccine.


VAERS ID: 1471841 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: coq10, vitamin D, vitamin B6, prenatal vitamins
Current Illness: D&C procedure
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe hives all over the body but mainly on stomach, and both legs very itchy. Hives are more severe in the evening. Treating them with over the counter anti-itch cream. Currently on day three and today hives were more severe.


VAERS ID: 1471843 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2020-12-21
Onset:2021-07-12
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: positive covid-19 test result, 07/13/2021
CDC Split Type:

Write-up: onset of URI symptoms on 07/12/2021 with a positive covid-19 test result, 07/13/2021


VAERS ID: 1474200 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-28
Onset:2021-07-12
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous
SMQs:, Termination of pregnancy and risk of abortion (narrow)

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

Write-up: My period started May 28 and my second vaccine was May 29. I found out I was pregnant June 27 and had a miscarriage on July 12. Not sure if this is related but my OB wanted me to report it.


VAERS ID: 1474308 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-03-07
Onset:2021-07-12
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Received Janssen vaccine on 3/7/21. Tested positive for COVID-19 by PCR on 7/12/21. Received monoclonal antibodies on 7/14/21.


VAERS ID: 1474318 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chills, Contusion, Erythema, Nausea, Peripheral swelling, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Atorvastatin, Cilostazol, Vitamins C, D, and a Multiple Daily vitamin.
Current Illness: None
Preexisting Conditions: Controlled blood pressure. Peripheral artery disease in legs.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme severe nausea lasting 48 hours, fever 101.9, chills, extreme weakness, chest pressure. Arm extremely red, bruised, hot and swollen. I did not seek medical care although I truly feared I was perhaps experiencing an heart attack. I am my husband''s sole caretaker and cannot leave him unattended.


VAERS ID: 1474319 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-25
Onset:2021-07-12
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Device function test, Dyspnoea, Electrocardiogram, Oxygen saturation decreased, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flomax, Imdur, Ecotrin, protonix, plavix, zoloft, norvasc, lipitor
Current Illness: Hypercholesterolemia, HTN disorer, DM2
Preexisting Conditions: Hypercholesterolemia, HTN disorer, DM2
Allergies: ACE inhibitors, MS contin, Gabapentin
Diagnostic Lab Data: EKG, loop recorder check
CDC Split Type:

Write-up: Syncopal episode, SOB, Low opxygen levels needing supplemental O2


VAERS ID: 1474332 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-23
Onset:2021-07-12
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Cardioversion, Condition aggravated
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Atrial fibrillation on June 27, 2021 after the same vaccine. Separate report filed.
Other Medications: Metoprolol (25mg), Levothyroxine (25mg)
Current Illness: N/A
Preexisting Conditions: I have a history of rare atrial fibrillation (once every few years), but have had it twice since receiving the vaccination.
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Second episode of atrial fibrillation since receiving Janssen COVID-19 vaccine. I had a heart rate of 180 BPM and again needed to be cardioverted.


VAERS ID: 1474454 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Injection site pruritus, Nausea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Allergic: Anaphylaxis-Mild, Additional Details: PATIENT EXPIRIENCED BRUSHING AND ITCHINESS NEAR THE INJECTION SITE AND ON FACE . PATIENT ALSO EXPIRIENCED NAUSEA. PATIENT SAID SYMPTOMS ARE GETTING BETTER. REFER TO SEE DOCTOR OR COME BACK TO PHARMACY IF ANY OF ABOVE MENTION SYMPTOMS GET WORSE


VAERS ID: 1474519 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complains of severe pain, swelling ("a bump"), itchiness, and redness at site of injection, which started a few hours after the shot. Patient reported side effects to the pharmacy 3 days after the injection, saying the pain and swelling has subsided after taking ibuprofen and acetaminophen and topical Benadryl to the site. Three days after injection, her only complaint is slight swelling and itchiness. Instructed her to take Benadryl at bedtime and continue ibuprofen if needed.


VAERS ID: 1474567 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-30
Onset:2021-07-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Disorientation, Dyspnoea, Magnetic resonance imaging abnormal, Portal vein thrombosis, Renal pain, Weight decreased
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen-ibuprofen, hydrochlorothiazide, irbesartan, metoprolol
Current Illness:
Preexisting Conditions: Diabetes mellitus, hypertension, obesity
Allergies: penicillin, sulfa drugs
Diagnostic Lab Data: CT scan, MRI
CDC Split Type:

Write-up: Patient came to the ED with SOB, kidney pain, weight loss, and disoriented. CT scan and MRI showed portal vein thrombosis. Patient is still inpatient at Hospital. Patient unable to give lot number or date of vaccination.


VAERS ID: 1474620 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-02
Onset:2021-07-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Hyperhidrosis, Injection site warmth
SMQs:, Neuroleptic malignant 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: Ibprofen and Tylenol
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Amoxicillin and Keflex, Cipro, Codeine, Loraset and Percoset, IV dyes, Soma,
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Left arm became hot to touch, headaches and sweating. Started on 07/12/2021


VAERS ID: 1474679 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram
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: vit D, folic acid
Current Illness:
Preexisting Conditions: vit D and iron deficiencies
Allergies: none
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: chest pain, dyspnea


VAERS ID: 1474777 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Brain natriuretic peptide normal, C-reactive protein normal, Chest X-ray normal, Chest pain, Electrocardiogram normal, Myalgia, Troponin normal
SMQs:, Rhabdomyolysis/myopathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Normal CRP, BNP, and troponin. Normal EKG and Chest xray.
CDC Split Type:

Write-up: Chest pain with myalgia, lasts about 30 seconds and occurs multiple times daily


VAERS ID: 1474790 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-06
Onset:2021-07-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Musculoskeletal stiffness, Peripheral swelling, Skin warm, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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:
Other Medications: None
Current Illness: No lines
Preexisting Conditions: None
Allergies: Keflex/Cipro
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 6 days post injection developed a welt on arm, but not at int site, Large Lymph node swelling on collarbone and stiff neck. 7 -14 additional welts on injection arm. Temperature on the arm is 96 on arm with swelling and 90 on non injection arm. Taking OTC benedryl and using OTC hydrocortisone on the 2 welts on int arm


VAERS ID: 1475205 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-02-25
Onset:2021-07-12
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: She tested positive for COVID on 07/14.
CDC Split Type:

Write-up: patient develop new loss of taste or smell, sore throat, nasal congestion on 07/12. She tested positive for COVID on 07/14.


VAERS ID: 1475859 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes virus infection, Menstrual disorder, Pelvic pain, Uterine pain
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot 2011 GI pain
Other Medications: Prenatal vitamins
Current Illness: Nki
Preexisting Conditions: C-section
Allergies: Penicillin and latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After both shots, I had pain in my uterus. Two days after my first shot, I had a sacral herpes attack while the pelvic/uterus pain persisted. Three days after the second shot, my menstruation started 12 days early. This was a 16 day cycle which has never happened to me. It has started and stopped several times.


VAERS ID: 1477787 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (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), 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-Mild, Systemic: Seizure-Mild


VAERS ID: 1478034 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-10
Onset:2021-07-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None. Took some Tylenol for Sore Arm after the Vaccine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Got COVID, post second shot of the vaccine


VAERS ID: 1478040 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-10
Onset:2021-07-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Got COVID less than 48 hours post second shot.


VAERS ID: 1478046 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

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

Write-up: Medical professional administering vaccine drew up wrong dose instead of the recommended dosage.


VAERS ID: 1478054 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Alanine aminotransferase, Aspartate aminotransferase, Blood albumin, Blood culture negative, Blood fibrinogen, Blood lactate dehydrogenase, Cardiac disorder, Chest X-ray, Differential white blood cell count abnormal, Echocardiogram abnormal, Electrocardiogram, Full blood count abnormal, Gait inability, Haemoglobin decreased, Inflammation, Lipase, Metabolic function test, Platelet count decreased, Platelet transfusion, Prothrombin time, SARS-CoV-2 test negative, Transfusion, Troponin I increased, Urine analysis normal, White blood cell count decreased
SMQs:, Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol 650 timed release He is on a medicine regimine for acute myloid leukemia
Current Illness: acute myeloid leukemia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest xray, EKG-7/13, Manual Diff, CBC, Troponin I, Lipase, Basic metabolic all in ED. Troponin was elevated to 80 leading them to suspect heart issues. On the floor all these were repeated over and over. Metabolic panel was fairly normal. They did PTT, PT, LDH, ALT, ASt, Albumin, Covid test which was negative, urinalysis normal, blood cultures normal, fibrinogen, troponin again 104, CBC where white count was 0.6, hemoglobin was 8.4, and platelets were 9. The last troponin was 70.. He had an echo of his heart which showed a decrease of compression compared to 2019 to have dropped from 60% to 40%. He has a heart issue now due to covid vaccine.
CDC Split Type:

Write-up: He had a huge Acute inflammatory response that required an ambulance transport due to his inability to walk. He needed fluids in the ED then dexamethasone which immediately changed his progress for the better. He then needed a blood transfusion due to low hemoglobin. He needed a platelet transfusion due to very low platelets. He had to stay for three and a half days.


VAERS ID: 1478107 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-02-12
Onset:2021-07-12
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Dyspnoea, Fibrin D dimer increased, Hypoxia, Intensive care, Pneumonia, Pulmonary oedema, SARS-CoV-2 test positive, Serum ferritin increased, White blood cell count increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Medications at time of admission: Apixaban, clopidogrel, finasteride, folic acid, losartan, montelukast, pantoprazole, pravastatin, tamsulosin
Current Illness:
Preexisting Conditions: Arteriosclerotic heart disease, BPH, GERD, HLD, HTN, PUD, osteoarthritis
Allergies:
Diagnostic Lab Data: 7/8 COVID test positive (per report) 7/12 CXR persistent/worsening multifocal PNA vs edema 7/14 Ferritin 1255
CDC Split Type:

Write-up: Presented to hospital for increased SoB and weakness. Diagnosed with COVID-19 on 7/8. Discharged home on 2L O2 and dexamethasone. On 7/12 presented again with hypoxia, elevated WBC/ D-dimer. O2 titrated to 5 L NC and transferred to our facility on 7/12. Oxygen requirement continued to increase and patient admitted to ICU on 7/14. Currently receiving dexamethasone and received tocilizumab 7/13. Received remdesivir initially but was discontinued on transition to HFNC$g Currently on HFNC w/NRB 50 L at 90%


VAERS ID: 1478207 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abscess limb, Cellulitis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt admitted on 7/9/2021 with cellulitis and abscess of right leg after receiving second dose of vaccine on 7/1. Per guidelines, all hospitalizations are reported.


VAERS ID: 1478247 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 20 mg PO daily Olmesartan 40 mg PO Daily Vitamin D3 125 mcg 1 Tab PO Daily Ibuprofen 600mg 1 Tab TID PRN Pain naproxen 500mg 1 Tab BID PRN Pain Relafen Ds 1000mg 1 Tab PO Q8hrs PRN Pain
Current Illness: None
Preexisting Conditions: Osteoarthritis knee; HTN; obesity; dyspnea
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Medical professional administering vaccine drew up 1ml instead of the recommended dosage of 0.5ml.


VAERS ID: 1478286 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Zolpidem, Levothyroxine, Multivitamins OTC
Current Illness: none
Preexisting Conditions: Nerve Issues, Thyroid Deficiency, Post-spine surgery, only 1 kidney
Allergies: Tramadol, Percocet, Toradol, Dilaudid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, swelling at and near the injection site, patient reports itching, pain & pain radiating down the arm to forearms. Fever was also initially reported but has subsided, body aches were also reported. At this time, patient has redness & swelling & pain....patient was instructed to do soft compresses around the site & take anti-inflammatory as directed by MD


VAERS ID: 1478417 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 - / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test abnormal, Dehydration, Fatigue, Malaise, Nausea, Palpitations, Renal impairment, Retching, Sleep disorder, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hydrocortisone, fludrocortisone, vitamin D, Vitamin B12, synthroid, zinc, multi vitamin women''s daily
Current Illness: mild concussion June 25th
Preexisting Conditions: Addison''s disease Thyroid disease very fit and healthy! 20-30,000 steps per day. Eat healthy, exercise and good heart and cholesterol levels.
Allergies: none
Diagnostic Lab Data: Blood work at the hospital 7/13. Just determined to be severe dehydration.
CDC Split Type:

Write-up: A fter the vaccine, I initially felt fine. During a bike ride I began to feel weak, tired and my heart was racing. When I got home I tried to take my blood pressure and the machine said error. I was very tired and weak. Before I went bed feeling quite nauseous and felt overall weak and felt ill. Blood pressure was 85/65. During the night I was up often trying to vomit. I had some slight vomiting but mostly dry heaves. I was laying on the bathroom floor. My husband woke up and took me to the hospital. I was admitted for severe dehydration to the point it affected my kidneys. I had IV fluids throughout the day and was able to go home late that afternoon. The weakness continued for about another day and a half. Still a bit off but better as of 7/16/21


VAERS ID: 1478439 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-17
Onset:2021-07-12
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Anosmia, COVID-19, Chills, Cough, Hyperhidrosis, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Hypersensitivity (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: DMII, Obesity
Allergies:
Diagnostic Lab Data: Covid Test: 7/14/21 ; Resulted positive 7/15/21
CDC Split Type:

Write-up: Covid positive after vaccination Patient has the following symptoms: cough, body aches, chills and sweats (no thermometer), anosmia, congestion, rhinorrhea, sneezing


VAERS ID: 1478468 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / IM

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

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

Write-up: Patient reported noticing a mild red rash on her ankles the night of her second Moderna shot (7/12/21), and noted that is started worsening the following night (7/13/21) and was spreading up the shins. Continued to spread and develop red welts that were painful to the touch over the next days. Reported to the pharmacy the evening of 7/15/21. Counseled patient to apply hydrocortisone cream to the affected areas, to take a dose of diphenydramine, and to contact her primary care physician for further evaluation. Later that evening, she was prescribed triamcinolone ointment to treat a diagnosis of hives.


VAERS ID: 1478479 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-19
Onset:2021-07-12
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucometer use as directed 1-2 times a day Test Strips use BID Lancets use BID as directed Ozempic (0.25 mg or 0.5 mg dose) 2 mg/1.5 mL solution 0.5 mg subcutaneously once a week Tricor 145 mg tablet take 1 tablet by mouth once
Current Illness:
Preexisting Conditions: Diabetes mellitus. Gout. Diverticulosis. Colon polyps (2012). vitamin D deficiency. Hyperlipidemia. Hypertensive disease NOS.
Allergies: NKDA
Diagnostic Lab Data: 7-14-2021 PCR tested at UTMB - result positive
CDC Split Type:

Write-up: Pt just got his + test for COVID-19 which were positive, pt has had some ? contacts at work, also he went to an Astros game where he may have been exposed; pt reports dry cough, mild malaise, denies any shortness of breath, no diarrhea, no changes in smell / taste.


VAERS ID: 1478525 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-03
Onset:2021-07-12
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Fatigue, Infection, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Congestive Heart Failure, Pacemaker/Defibrillator
Allergies: Unknown
Diagnostic Lab Data: COVID-19 NAAT Positive and PCR positive
CDC Split Type:

Write-up: Breakthrough COVID-19 case and hospitalized. Patient experiencing fever, cough, chills, fatigue, rigors and shortness of breath since 7/12/21. Patient has congestive heart failure and has a pacemaker/defibrillator. Reports having shortness of breath at baseline at times.


VAERS ID: 1478530 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

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

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

Write-up: Administration error: following administration of the J&J vaccine dose on 7/12/21, our staff member began entering the vaccine information into our computer system. It was at that time she discovered the patient had already completed a vaccine series with Pfizer vaccine (dose #1 on 1/4/21, lot#EL3246; dose #2 on 1/25/21, lot# EL3246). Staff notified patient that this J&J vaccine was not needed and may increase risk of adverse effects. Patient confirmed that the was aware this was an additional dose and this was intended by her. No adverse effects noted during the observation perior.


VAERS ID: 1478544 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Incorrect dose administered, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metFORMIN 1000 mg tablet 1 tab(s) orally 2 times a day glimepiride 2 mg tablet 1 tab(s) orally BID, stop date 08/16/2021 Atorvastatin Calcium 10 mg tablet 1 tab(s) orally once a day, stop date 08/16/2021
Current Illness: None
Preexisting Conditions: 1. Type 2 diabetes mellitus without complication, without long-term current use of insulin - E11.9 (Primary) 2. Hyperlipidemia, unspecified hyperlipidemia type - E78.5 3. Right knee pain - M25.561
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient was given Moderna 1 ml instead of 0.5 ml on 7/12/2021. Outcome: Patient experienced a fever on 7/13/2021, took Tylenol, symptoms resolved. No other symptoms, no need for ER visit.


VAERS ID: 1478596 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Pain
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluticasone Propionate 50 mcg/inh spray 1 spray(s) intranasally once a day ZyrTEC 10 mg tablet 1 tab(s) orally once a day Lipitor 20 mg tablet 1 tab(s) orally once a day ferrous sulfate 325 mg tablet 1 tab(s) orally 3 times a day
Current Illness: On 06/24/2021 Pt c/o cough, sore throat, onset 06/14/2021. Denies sick contact, covid-19 no exposure.
Preexisting Conditions: J31.0 Rhinitis K29.70 Gastritis E55.9 Low vitamin D level J45.909 Asthma E89.0 Status post thyroidectomy Z68.33 BMI 33.0-33.9,adult F25.0 Schizo affective schizophrenia E78.5 Hyperlipidemia D50.9 Microcytic anemia R41.3 Memory problem H52.4 Presbyopia
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: On 7/12/2021 patient was given Moderna 1 ml instead of 0.5 ml. Outcome: Follow up call on 7/16/2021. Patient stated she had bodyaches on 7/12/2021 after the injection. She took Ibuprofen 600 mg and rested. No symptoms the following day. No need for an ER visit. Doing well.


VAERS ID: 1478624 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Dizziness, Headache
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: EFFEXOR; Gabapentin; SUDAFED; ZYRTEC
Current Illness: None disclosed by patient during pre-vaccination assessment.
Preexisting Conditions: None disclosed by patient during pre-vaccination assessment.
Allergies: Sulfa & Penicillin
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Patient experienced dizziness, headache, and abdominal cramping after administration of Moderna COVID-19 vaccine. Observed for 1 hours. VS WNL. Advised to call PCP and to call 911 if S/S resume or worsen. Released to family. VS: Initial @ 1215: BP 130/80; HR 72; RR 20; Temp 97.3; Abdominal Pain 8/10. 2nd @ 1220: BP 120/80; HR 80; RR 20; Abdominal Pain 6/10. 3rd @ 1240: BP 112/92; HR 74; RR 18; Abdominal Pain 3/10. Disposition: S/S improved. RN deemed patient stable. Released to family.


VAERS ID: 1478699 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Sore throat , body ache , fever , chills


VAERS ID: 1478862 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-09
Onset:2021-07-12
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 UN / IM

Administered by: School       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Arrhythmia, Arteriogram coronary normal, Aspartate aminotransferase increased, Bilirubin conjugated increased, Blood bilirubin increased, Brain natriuretic peptide normal, C-reactive protein increased, Chest X-ray normal, Coxsackie virus test, Cytomegalovirus test negative, Drug screen positive, Echocardiogram normal, Ejection fraction normal, Electrocardiogram ST segment elevation, Enterovirus test negative, Epstein-Barr virus antibody positive, Fibrin D dimer normal, HIV antibody negative, HIV antigen negative, Intensive care, Myocarditis, Parvovirus B19 test positive, Respiratory viral panel, SARS-CoV-2 test negative, Substance use, Troponin increased, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Myocardial infarction (narrow), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Drug abuse and dependence (broad), Biliary system related investigations, signs and symptoms (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen, daily multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 7/13: CRP 6.68 (nl 0.46-2.42), troponin 16.859 (nl <0.021), BNP normal, D-Dimer normal. SARS-CoV-2 PCR negative. Respiratory pathogen PCR panel negative. CXR negative. CT heart coronary angiogram normal. EKG: ST elevation in the inferolateral leads, consider pericarditis or myocardial injury; ECHO: Low normal left ventricular systolic function. LVEF measures 54.1% by bullet method. 7/14: Troponin 21.607, 49.733, 37.250. Urine drug screen positive for marijuana. ECHO normal. Plasma enterovirus PCR negative. Parvovirus and EBV serology consistent with past infection. CMV serology negative. HIV Ag/Ab negative. Coxsackie B viruses antibodies pending. 7/15: Troponin 18.964, AST 61, ALT 26, Total bilirubin 1.1, Direct bilirubin 0.5. 7/16 Troponin 2.707.
CDC Split Type:

Write-up: Myocarditis with onset 7/12, worse on 7/13 and admitted to hospital to Cardiology service. Had non-sustained ventricular tachycardia and was transferred to the cardiac ICU on 7/14 morning and placed on a lidocaine drip. He had no further arrhythmia, and lidocaine was stopped and transferred out of CICU on 7/15.


VAERS ID: 1479079 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-12
Onset:2021-07-12
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid Test 7/15/21- POSITIVE
CDC Split Type:

Write-up: Covid positive after vaccination


VAERS ID: 1481138 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Oregon  
Vaccinated:0000-00-00
Onset:2021-07-12
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Off label use
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210725279

Write-up: JANSSEN VACCINE TAKEN AFTER TWO DOSES OF PFIZER; OFF LABEL USE; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient was previously treated with bnt 162 for prophylactic vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, expiry: 24-JUL-2021) dose was not reported, administered on 12-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-JUL-2021, the subject experienced janssen vaccine taken after two doses of pfizer. On 12-JUL-2021, the subject experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the janssen vaccine taken after two doses of pfizer and off label use was not reported. This report was non-serious.


VAERS ID: 1481148 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-07-12
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Dyspnoea, Painful respiration, Pyrexia, Speech disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210712; Test Name: Body temperature; Result Unstructured Data: 39 degrees celsius
CDC Split Type: USJNJFOC20210725353

Write-up: DIFFICULTY IN BREATHING; PAIN IN BREATHING; DIFFICULTY SPEAKING; TEMPERATURE 39 DEGREE CELCIUS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 12-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-JUL-2021, the subject experienced difficulty in breathing. On 12-JUL-2021, the subject experienced pain in breathing. On 12-JUL-2021, the subject experienced difficulty speaking. On 12-JUL-2021, the subject experienced temperature 39 degree celcius. Laboratory data included: Body temperature (NR: not provided) 39 degree celcius. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from difficulty in breathing, pain in breathing, and difficulty speaking, and the outcome of temperature 39 degree celcius was not reported. This report was non-serious.


VAERS ID: 1481154 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-07-12
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Overdose
SMQs:, Drug abuse and dependence (broad), 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: Alcohol abuse; Alcohol use (alcohol dependence: 7 cans of beer per week); Allergic rhinitis; Chronic pain; Hypertension; Knee osteoarthritis; Nicotine dependence; Rosacea; Tobacco user (0.25 packs per day)
Preexisting Conditions: Medical History/Concurrent Conditions: Cataracts; Leg fracture; Pruritic rash; Pterygium; Comments: The patient had no known allergies. The patient did not have any drug abuse/illicit drug use. The patient was not pregnant.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210725703

Write-up: RECEIVED THE VACCINE TWICE/VACCINE OVERDOSE; This spontaneous report received from a pharmacist concerned a 57 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included cataracts, fracture of lower leg, pruritic rash, and pterygium, and concurrent conditions included allergic rhinitis, chronic pain, hypertension, nicotine dependence, osteoarthritis of knee, tobacco use/smoker, rosacea, non dependent alcohol abuse, and alcohol user, and other pre-existing medical conditions included the patient had no known allergies. the patient did not have any drug abuse/illicit drug use. the patient was not pregnant. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, and batch number: 206A21A expiry: 07-AUG-2021) dose was not reported, administered on 23-JUN-2021, and dose was not reported, administered on 12-JUL-2021 for prophylactic vaccination. The first dose batch number was not reported and has been requested. No concomitant medications were reported. On 12-JUL-2021, the subject experienced received the vaccine twice/vaccine overdose. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of received the vaccine twice/vaccine overdose was not reported. This report was non-serious.


VAERS ID: 1481194 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Alaska  
Vaccinated:0000-00-00
Onset:2021-07-12
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, SARS-CoV-2 test
SMQs:, Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergy
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (The patient already had Covid in Dec or January)
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 PCR test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210727807

Write-up: SORE ARM; This spontaneous report received from a patient concerned a 62 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included covid-19, and concurrent conditions included seasonal allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1205A21A expiry: UNKNOWN) dose was not reported, administered on 12-JUL-2021 10:45 for prophylactic vaccination. No concomitant medications were reported. On 12-JUL-2021, the subject experienced sore arm. Laboratory data (dates unspecified) included: COVID-19 PCR test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from sore arm. This report was non-serious. This case, from the same reporter is linked to 20210728046 and 20210733974.


VAERS ID: 1481209 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Alaska  
Vaccinated:0000-00-00
Onset:2021-07-12
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 025A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Pain in extremity, SARS-CoV-2 test
SMQs:, Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202012; Test Name: COVID-19 PCR test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210728046

Write-up: PAINFUL SORE ARM; BAD HEADACHE; FATIGUE; This spontaneous report received from a consumer concerned a 57 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 025A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-JUL-2021 10:45 for prophylactic vaccination. No concomitant medications were reported. On DEC-2020, Laboratory data included: COVID-19 PCR test (NR: not provided) Positive. On 12-JUL-2021, the subject experienced painful sore arm. On 12-JUL-2021, the subject experienced fatigue. On 12-JUL-2021, the subject experienced bad headache. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from bad headache, fatigue, and painful sore arm. This report was non-serious.


VAERS ID: 1481496 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-07
Onset:2021-07-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: SEASONAL ALLERGIES
Preexisting Conditions: LUPUS ARTHRITIS ANEMIA THYROID ISSUES
Allergies: MEDICATIONS- FLEXERIL (HIVES) FOODS/OTHER PRODUCTS- SHE STATED WHEN SHE WAS YOUNGER, SHE WAS TESTED AND HAD "LOTS OF ALLERGIES" FROM TESTS. NOT AWARE OF EFFECTS.
Diagnostic Lab Data: N/A2
CDC Split Type:

Write-up: PATIENT CALLED PHARMACY ON 7/17/21 AND TOLD US SHE GOT THE VACCINE ON 7/7/21. SHE HAD NO SIDE EFFECTS, UNTIL MONDAY 7/12/21 WHEN SHE WENT TO URGENT CARE AND DIANGOSED WITH SHINGLES. SHE SAID THEY WERE PRESENT ON HER HIP.


VAERS ID: 1481534 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-09
Onset:2021-07-12
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

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

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

Write-up: Fully vaccinated for covid in January 2021. Cold symptoms on 7/12 started. Tested covid positive 7/16.


VAERS ID: 1481538 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Injection site swelling, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? 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: Insulin
Current Illness:
Preexisting Conditions: Diabetic
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling in left arm, chills, breathing difficulties, left arm hot to touch. These are still persisting.


VAERS ID: 1481567 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Presyncope, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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: Covid Pfizer first dose 6/4/21
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had a reaction to first dose and came back for second dose. Hospital said she was fine to get it and it was not a seizure but she should eat before the dose this time. Pharmacist discussed incidence with her and she agreed to wait in lobby for 30 minutes. patient received vaccine and was walked to lobby to sit. She got up a few minutes later to report feeling dizzy. She walked over to consultation window and fainted before pharmacist could reach her. She came to immediately, 911 was called and they said she had a vasovagal reaction. She declined going to hospital as she felt fine and sat for 30 more minutes before leaving.


VAERS ID: 1481569 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Loss of consciousness, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Centrum for men supplement, Pravastatin 20mg, Lisinopril 40mg
Current Illness: None
Preexisting Conditions: episodic ataxia
Allergies: None
Diagnostic Lab Data: None this happened at home with no doctor involvment
CDC Split Type:

Write-up: Got very dizzy which caused me to collapse. I then had a seizure where my eyes went up in my head and lost consciousness for a few minutes.


VAERS ID: 1481627 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-18
Onset:2021-07-12
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood magnesium normal, Differential white blood cell count normal, Full blood count normal, Heavy menstrual bleeding, Human chorionic gonadotropin normal, Hyperhidrosis, Laboratory test normal, Lipase normal, Liver function test normal, Menstrual disorder, Metabolic function test normal, Oligomenorrhoea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 100mcg daily
Current Illness: None
Preexisting Conditions: None
Allergies: Shrimp
Diagnostic Lab Data: Was taken to the hospital by ambulance and was given hydration. Labs completed and normal - Basic metabolic panel, CBC & differential, HCG, LFTs, Lipase, Magnesium
CDC Split Type:

Write-up: July 12 - Painful abdominal cramps and profuse sweating all over my body. 10 mins after cramps and sweating started, I started my period. Sweating lasted about an hour, while the cramps lasted a couple of hours. There was very little blood, but a lot of ?water? in my maxi pad. My periods are usually three days long, with only one heavy day. I am on my sixth day and have had a heavy flow each day. There still is very little blood but a lot of ?water.?


VAERS ID: 1481688 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-10
Onset:2021-07-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye discharge, Eye irritation, Eye pain, Eyelid margin crusting, Lacrimation increased, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Glaucoma (broad), Corneal disorders (broad), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow)

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

Write-up: Awoke that morning with my right eye crusted shut. Just right eye was red and watery until Wednesday 7/14/2021. By Wednesday afternoon my left eye also became red and watery with thick discharge near the evening. There was no eye pain until Friday 7/16/2020. As of Saturday 07/17/2021 both eyes are still red and have a general feeling of irritation.


VAERS ID: 1482064 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-29
Onset:2021-07-12
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Blood test, Chest X-ray, Electrocardiogram, Pleurisy, Urine analysis
SMQs:, Systemic lupus erythematosus (broad), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Eperlone 25 mg
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: Ceclor
Diagnostic Lab Data: Blood work Urinalysis EKG Chest X-ray
CDC Split Type:

Write-up: On 7/12/21 started getting sharp pains left side it felt like it was in my heart then on July 13, 2021 I want to hospital. The ER they did bloodwork many test chest x-ray the final diagnosis was pleurisy. I have never had any lung issues in my life except asthma when I was a young child which I out grew it as a teenager. I am following up with a pulmonologist on Monday, July 19, 2021 as advised.


VAERS ID: 1483807 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Gait disturbance, Headache, Muscle spasms, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin
Current Illness: none
Preexisting Conditions: History of stroke, blood clots
Allergies: Latex, Azithromiacin, Hydrocodone
Diagnostic Lab Data: I emailed my primary care physician describing the symptoms of the fatigue, muscle pain and the rash and she told me that the fatigue and muscle pains are common with the vaccine but that i should report the rash to the CDC so that''s why i am filling out this report. I no longer have the rash on my neck and chest but i do still have the extreme fatigue after 6 days now since my vaccine.
CDC Split Type:

Write-up: Upon first receiving the vaccine within about 15 minutes i felt very dizzy, this lasted about a half hour. i was released to leave at about 12:50 after sitting in a waiting room at Pharmacy, city state location which is where i received my vaccine. After leaving i again felt very dizzy almost as if i couldn''t walk straight. Within the first 24 hours of having the vaccine i developed severe muscle cramps and fatigue, along with a pretty bad headache. I then developed a very itchy and red rash on my neck and chest that lasted about a day. I had extreme fatigue following this vaccine and still have extreme fatigue today, which is 6 days after the vaccination.


VAERS ID: 1483926 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-16
Onset:2021-07-12
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis, Computerised tomogram, Fatigue, Headache, Magnetic resonance imaging, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Embolic and thrombotic events, venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall xr 10, Lisinopril, Atorvastatin,
Current Illness: none
Preexisting Conditions: no
Allergies: Shellfish, Penicillin
Diagnostic Lab Data: CT Scans on 7/13 and 7/14 MRI on 7/14
CDC Split Type:

Write-up: Headache, fatigue led to blood clot in the head and a seizure. _ diagnosis - Accute cerebral venous thrombosis (superior sagittal sinus{.


VAERS ID: 1483935 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-03-01
Onset:2021-07-12
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: tested positive for COVID on 07/16
CDC Split Type:

Write-up: Patient states that he was fully vaccinated for COVID with Moderna vaccine in March. we do not have his vaccine information on file, but he will be emailing us a copy of his COVID vaccination card when he finds it, and you may contact his PCP for the relevant information on the card.) He was exposed to someone with COVID on 07/12, developed symptoms of COVID on 07/12 and tested positive for COVID on 07/16.


VAERS ID: 1484061 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-30
Onset:2021-07-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWD0187 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWD0187 / 2 RA / IM

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

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

Write-up: Developed a small rash (red itchy bumps)1 week after covid vaccine. 2 weeks later it spread down my arms, legs and torso. Seems to go away with antihistamines, the reactions happen off and on.


VAERS ID: 1484570 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Cough, Fatigue, Lower respiratory tract infection, Myalgia, Nausea, Oropharyngeal pain, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid-19 test: negative
CDC Split Type:

Write-up: Sore throat, extreme fatigue first three days, developed into chest infection, coughing, persistent extreme fatigue. Slight sore muscles. Attempt at physical activity caused near collapse from nausea, and chest pain around heart.


VAERS ID: 1484579 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-12
Onset:2021-07-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis, Claritin, Vitamin D, Vitamin B12, Visine
Current Illness: Blood clot disorder, Anemia
Preexisting Conditions: Blood clot disorder, Anemia
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated left deltoid. Approximately 20 minutes after patient received vaccine she notified that she was having swelling in her left forearm. She did have minor swelling noted mid-posterior forearm, No SOB, no cough, no rash, no itching, She was referred to see the clinic physician who evaluated her and had her return for follow up the next day. On follow up visit she advised she also had some swelling of her left leg which was evaluated by the MD, Continued with no other complaints.


VAERS ID: 1484608 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-26
Onset:2021-07-12
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8722 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data: reference lab, date collected 7/14/2021
CDC Split Type:

Write-up: I have tested positive (and am showing symptoms of) COVID-19 four months after receiving my vaccine. I am on day 8 of showing symptoms.


VAERS ID: 1484673 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-04
Onset:2021-07-12
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Headache, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 RNA increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test date: 7/15/2021 Test performed: SARS-rel CoV RNA Resp Ql NAA+probe~SARS-CoV-2 Route: nasopharyngeal Result: POSITIVE
CDC Split Type:

Write-up: Sx onset: 7/12/21 cough, runny nose, sore throat, fever, headache, loss of smell & loss of taste. Tested for COVID-19 on 7/15/21 which returned as positive.


VAERS ID: 1484676 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-11
Onset:2021-07-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Hx of febrile seizures
Allergies: none
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: One day after receiving the vaccine (her second covid vaccine) she had a convulsive syncopal episode.


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