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From the 9/17/2021 release of VAERS data:

Found 711,579 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 284 out of 7,116

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VAERS ID: 1529183 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-29
Onset:2021-08-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Conjunctival haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Conjunctival 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Subconjunctival hemorrhage


VAERS ID: 1529212 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029K20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Extra dose administered, Fatigue, Headache, Interchange of vaccine products, Palpitations, Pyrexia, Wrong product administered
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Arthritis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I received my COVID (moderna) vaccines on 2/13/21 and 3/13/21. My doctor gave me orders to get my shingles vaccination. My first shot was given at Walgreens on 6/3/21. When I went to get my second shingles vaccination at Walgreens on 8/3/21, I was mistakenly given an additional COVID (pfizer) vaccination. On 8/4/21 I started having headaches unresolved by medication, heart palpitations, fatigue, joint pain, and low grade fever. I reported it to physician on 8/4/21 and the Department of Health and Environmental Control on 8/5/21. I was told to monitor my symptoms and stay hydrated. If the palpitations do not subside to contact my physician or call 911 if my condition gets any worse.


VAERS ID: 1529219 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Heart rate increased, Sensation of foreign body, Throat irritation, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Dehydration (broad)

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

Write-up: Client was given a 2nd dose of the Covid 19 Pfizer vaccine in his L/deltoid. About 5-10 minutes later the client c/o a scratchy throat and that it felt like it was closing. I immediately got the epi and prepared it for administration (0.5ml). Client was still able to verbalize and stated that his throat felt funny and was feeling tight. At that point I gave him the epi injection into his Right Lateral thigh/IM. At that point I did take his vitals 122/72,78, 18, O2 99%, 96.9 and followed with a lung and chest auscultation (wheezing heard in chest area) .Safety was maintained throughout the incident. The client continued to breath regular and unlabored. 5-10 minutes later the client stated he could breath better and his throat did not have the lump, it was gone from his throat. After the injection his heart rate increased ( HR 115bpm). re-took the vitals 104/62 b/p, 84 p, t,97.0, O2 100%.. Mom was present and the events was explained via her son who remain alert and oriented throughout the event. She did express an understanding and I informed her of the importance of following up with the clients primary care doctor. The client continued to recover and vitals remained with normal limits (pulse 64 and O2 100%). No wheezing was heard in chest area on follow up auscultation and client asked for water. So. I assessed his swallowing with a small sip of water and he had no difficulty swallowing. I had him stand and his gait was steady, but I did keep him an extra 30 minute for observation. He remained stable and was discharged to his mom and self ambulated to the vehicle with out incident. On 08/04/21 I called just to follow-up and the client and mom was at the doctors office and he stated he was okay.


VAERS ID: 1529222 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-08
Onset:2021-08-03
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Condition aggravated, Cough, Dyspnoea, Hypogammaglobulinaemia, Hypoxia, Immunoglobulin therapy, Nasal congestion, Sinusitis
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

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

Write-up: Pt presented to the ED on 8/3/21 with 1 week of cough, weakness, and nasal congestion. She was started on antibiotics for a sinus infection, but her symptoms worsened despite this. She was tested for COVID on 8/2 at her PCP''s office and the test came back positive despite receiving both doses of Moderna vaccination on 2/10 and 3/8. Pt started to feel worsening shortness of breath on 8/3 and presented to the ED for work-up. Pt was found to be hypoxic and was started on 2L O2. She was admitted to the hospital on 8/3 for COVID treatment (remdesivir and dexamethasone). Pt has a hx of Parkinson''s, CLL, HTN, and dyslipidemia. She was also given IVIG on 8/5 per Hematology d/t hypogammaglobulinemia due to CLL.


VAERS ID: 1529275 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dysgeusia, Herpes zoster, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal
Current Illness:
Preexisting Conditions: Celiac Disease, neurological functional disorder
Allergies: None
Diagnostic Lab Data: Office Visit. Pictures Taken. A COVID Test was also performed.
CDC Split Type:

Write-up: I developed Shingles and now have to be treated for shingles with accompanying symtoms. In addition, I had pressure on my chest and a metalic taste in my mount for the first day or so.


VAERS ID: 1529277 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Bone disorder, Pain
SMQs:, Arthritis (broad)

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

Write-up: Patient describes whole body pain, feels burning inside joints, twisting across the bones


VAERS ID: 1529278 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-20
Onset:2021-08-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dermatitis contact, Rash, Rash erythematous
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: RED, POISON-IVY TYPE RASH ON ARMS, CHEST, LEGS, BACK, STOMACH. RASH HAS BEEN MOVING AROUND THE BODY AND SPREADING. TREATING WITH OTC REMEDIES.


VAERS ID: 1529283 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles
Other Medications: Rosuvastatin Ramipril Farxiga Metformin Amlodipine Metoprol Vitamin D
Current Illness: None
Preexisting Conditions: Blood pressure, pre diabetes
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vomiting Vertigo High Fever Headache


VAERS ID: 1529296 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol 100mg daily, Ibuprofen 800mg as needed
Current Illness: None
Preexisting Conditions: Gout
Allergies: Tramadol
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 8/3/2021 at 09:18am Patient reported that he felt like his heart raced. He became diaphoretic and lightheaded and laid down on the floor. His legs were elevated, wet cloth applied to forehead, staff fanning patient, pulse checked and was strong and rhythmic with no irregularities noted, respirations were even and unlabored with no signs of airway compromise. Denied shortness of breath, or chest pain. Patient was assisted up to a wheelchair by staff and taken across the street to emergency room where he checked in at 9:26am. He was treated and discharged home.


VAERS ID: 1529327 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / IM

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

Write-up: presented with red, non itchy rash surrounding injection site


VAERS ID: 1529356 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient presented to health clinic as a walk-in for COVID-19 vaccination. Patient self-disclosed as NOT having received any prior COVID-19 vaccines. Patient vaccinated with J&J vaccine per our protocol with questionnaire and consents signed. Upon entry of vaccination record into our EMR system, it was discovered that the patient had in fact received one dose of the Pfizer COVID-19 vaccine on 03-23-2021. Patient had no ill effects from J&J vaccine administration. This was a matter of additional vaccine given as well as different manufacturer.


VAERS ID: 1529360 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Emotional distress, Fall, Head injury, Nervousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient received modern vaccine. Was told to wait for signs for allergic reaction. While he was waiting he became dizzy. He tried to get up thinking he would feel better. He had signs of syncope. Female that was accompanying tried to stop him from falling but could not hold him and fell to ground. I was walking back from isle after helping a customer when I saw him already fallen to ground. Female picked him up and put him on chair. I stayed with him the entire time. He was talking and alert. Intern had already called 911. I put cool compress behind neck. I asked if he felt ok. He said he was ok just nervous .He kept apologizing and seemed more embarrassed. I assured him that it happens to some people and nothing to be sorry about. His pulse was good and was talking to us the entire time. He also drank some water. EMT arrived took vitals which were all fine. They suggested he go get head scan since he hit his head when he fell. He agreed and walked out with EMT.


VAERS ID: 1529362 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient presented to health clinic as a walk-in for COVID-19 vaccination. Patient self-disclosed as NOT having received any prior COVID-19 vaccines. Patient vaccinated with J&J vaccine per our protocol with questionnaire and consents signed. Upon entry of vaccination record into our EMR system, it was discovered that the patient had in fact received one dose of the Pfizer COVID-19 vaccine on 03-23-2021. Patient had no ill effects from J&J vaccine administration. This was a matter of additional vaccine given as well as different manufacturer.


VAERS ID: 1529397 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-28
Onset:2021-08-03
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Nasal congestion, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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: The patient was seen in the clinic by a provider for cough, headache, sneezing, and nasal congestion x3 days. He noted to receive the Pfizer Covid shot in 02/2021, however tested (+) Covid 19 during office visit.


VAERS ID: 1529405 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

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

Life Threatening? Yes
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: Keppa Lamotrigine Levothoxyorine
Current Illness: Had just been released after 6 months seizure free. Last seizure was 1/27/21 released by Neurology on 8/3/21
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I have contacted the pharmacy. They are my pharmacy and distribute the medications I take for seizures. No further treatment was needed at that time and thus far has not triggered additional seizures. It looks like I had a bad reacton to the shot.
CDC Split Type:

Write-up: I had a seizure Nov 5, 2020. My last seizure was Jan 27, 2021. I had just passed my 6 months seizure free and had been relased by neurologist to return to work and drive. That very same day I received my 1st shot, I believe it was the Moderna. About 3 hours after injection I had a seizure. My sister knew what was happening, initially called 911 but then told them she had it under control.


VAERS ID: 1529411 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-08-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is fully vaccinated and has tested positive for COVID-19


VAERS ID: 1529424 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-08-03
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is fully vaccinated and has tested postive for COVID-19


VAERS ID: 1529425 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-29
Onset:2021-08-03
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-05
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: positive covid19 PCR test result 8/4/21
CDC Split Type:

Write-up: fully vaccinated (Pfizer, 1/8/21, 1/29/21); onset of symptoms 8/3/21


VAERS ID: 1529433 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Hypotension
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Patient became dizzy, flushed, and visibly diaphoretic. Patient stated he felt like he was going to pass out. Patient taken to a private observation room. Patient hypotensive. All other vital signs stable. Juice offered and patient placed in recumbent position. Patient recovered within 15 minutes for a total observation period of 30 minutes. Patient walked out of clinic with mother in stable condition.


VAERS ID: 1529435 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

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

Write-up: Fever, fatigue, chills approximately 12 hours after vaccine. Ibuprofen reduced these symptoms. Approximately 36 hours after vaccine (morning of august 4th) experienced tightness in chest, cough, and fatigue. Still experiencing these symptoms as of 7pm august 5th.


VAERS ID: 1529598 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-28
Onset:2021-08-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash, Lymph node pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient has experienced a red quarter sized rash at the site of injection on 8/3/21 and has now expanded up her arm towards her next and is itchy. No fever or infection lines. Patient''s lymph nodes under that same right arm are inflamed and a little painful. Otherwise, patient feels fine.


VAERS ID: 1529602 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-08-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / UNK LA / SYR

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

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

Write-up: Swollen arm/muscle just below injection site. Red and warm to touch.


VAERS ID: 1529614 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Mobility decreased
SMQs:, Parkinson-like events (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Wrist and elbow pain cant bend wrist never had a problem before...started feeling pain a few hours after shot and now its 2 day now and wrist feels like its getting worse


VAERS ID: 1529617 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

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

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

Write-up: was administered by another pharmacist. pt was sitting & started to feel dizzy 5 minutes after her 1st dose. her father recognized her dizziness & called help. pt was given water and dad elevated her leg by placing them on the chair. Pt stated thae she was dizzy because she got the dose empty stomach. & her dad reported prior history of dizziness after immunization in doctor''s office. symptoms improved in 5 mins & she was monitored for further adverse events for another 30 mins


VAERS ID: 1529736 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Angina pectoris, Dizziness, Dyspepsia, Headache, Hemianaesthesia, Hemiparaesthesia, Hypoaesthesia, Immediate post-injection reaction, Inflammation, Nausea, Painful respiration, Paraesthesia, Pollakiuria, Thirst, Vision blurred, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: d3, zinc, C
Current Illness: none
Preexisting Conditions: Neck injury, slipped disc
Allergies: Shrimp, Penicillin
Diagnostic Lab Data: None, just vitals and listened to lungs. Said I sounded wheezy
CDC Split Type:

Write-up: Instant tingling down my arm, headache, dizzy, blurred vision. Went home, tingling spread to legs and jaw. In the morning , my left side of body, arms and legs tingling and numb. Chest feels inflamed and hurts to take deep breaths. Indigestion, frequent urination, very thirsty nausea, intense dizziness. Sharp stabbing pains through the day in heart and stomach. Went to ER Was only given steroid inhaler


VAERS ID: 1529742 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Nausea, 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)

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

Write-up: Patient is complaining of nausea and vomiting, not being able to keep food down. fever and chills.


VAERS ID: 1529743 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Hypertension, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: Patient experienced rapid heart palpitations and difficulty breathing but shortly after she was able to breath. pharmacist called the ambulance , when paramedics came , they checked the patient vitals . her heart beat and blood pressure was slightly high but vitals came down after 15 minutes and when they checked her vitals for the third time. vitals were in normal ranges. patient was asked if she wants to go to the hospital but she refused . paramedics left after patient claimed that she is feeling okay. Minutes after paramedics left patient started to have a rapid heart beat again.so pharmacist called the ambulance for the second time and when they came patient was taking to the hospital.


VAERS ID: 1529746 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Circumstance or information capable of leading to medication error, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Parent falsified the consent form to make patient appear older to be edible for vaccine.


VAERS ID: 1529757 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Dysstasia, Fatigue, Headache, Hyperhidrosis, Influenza, Pain, Pollakiuria, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocodone 10mg
Current Illness: None
Preexisting Conditions: Back pain
Allergies: None known
Diagnostic Lab Data: Didn''t seek medical care.
CDC Split Type:

Write-up: Feverish with chills and sweats. Every joint hurt when standing. Fatigue. Mild headache, deep in my head only. Extreme flu symptoms. Off and on frequent urination.


VAERS ID: 1530001 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O27C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Pain in extremity, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe joint pain, fever, pain and swelling in arm, headache


VAERS ID: 1530466 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: D.C.  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abnormal sensation in eye, Asthenia, Diarrhoea, Eye pain, Fatigue, Headache, Hypersomnia, Pain in extremity
SMQs:, Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy
Preexisting Conditions: Comments: Patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210804906

Write-up: FEELS LIKE EYES ARE BULGING; EYE PAIN FROM THE HEADACHE; WAS DRIFTING OFF; CALF PAIN/CALVES ARE ACHING A BIT BUT THAT MIGHT BE FROM LOW ENERGY; A FEW EPISODES DIARRHEA; FATIGUE/FEELING PRETTY DRAINED; LOW ENERGY/DOES NOT HAVE ENOUGH ENERGY TO GET OUT OF BED; HEADACHE; This spontaneous report received from a patient concerned a 63 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included penicillin allergy, no alcohol, and non smoker, and other pre-existing medical conditions included no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286, expiry: UNKNOWN) dose was not reported, administered on 02-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the subject experienced feels like eyes are bulging. On 03-AUG-2021, the subject experienced eye pain from the headache. On 03-AUG-2021, the subject experienced was drifting off. On 03-AUG-2021, the subject experienced calf pain/calves are aching a bit but that might be from low energy. On 03-AUG-2021, the subject experienced a few episodes diarrhea. On 03-AUG-2021, the subject experienced headache. On 03-AUG-2021, the subject experienced fatigue/feeling pretty drained. On 03-AUG-2021, the subject experienced low energy/does not have enough energy to get out of bed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fatigue/feeling pretty drained, had not recovered from a few episodes diarrhea, headache, low energy/does not have enough energy to get out of bed, eye pain from the headache, calf pain/calves are aching a bit but that might be from low energy, and feels like eyes are bulging, and the outcome of was drifting off was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious


VAERS ID: 1530479 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chest pain, Chills, Hyperhidrosis, Illness, Muscle twitching, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Body temperature; Result Unstructured Data: 99.6 F
CDC Split Type: USJNJFOC20210806466

Write-up: CHEST HURTS/PAIN; SWEATING; TWITCHING; VERY SICK; CHILLS; FEVER; This spontaneous report received from a parent 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 03-AUG-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 03-AUG-2021, the subject experienced very sick. On 03-AUG-2021, the subject experienced chills. On 03-AUG-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 99.6 F. On 04-AUG-2021, the subject experienced chest hurts/pain. On 04-AUG-2021, the subject experienced sweating. On 04-AUG-2021, the subject experienced twitching. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chest hurts/pain, sweating, twitching, chills, fever, and very sick. This report was non-serious.


VAERS ID: 1530486 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Insomnia, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210807711

Write-up: ACHY EVERYWHERE; COULDN''T SLEEP; FEELS HORRIBLE; FEVER; NAUSEA; This spontaneous report received from a parent concerned a 22 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: 1820095, expiry: UNKNOWN) dose was not reported, administered on 03-AUG-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the subject experienced achy everywhere. On 03-AUG-2021, the subject experienced couldn''t sleep. On 03-AUG-2021, the subject experienced feels horrible. On 03-AUG-2021, the subject experienced fever. On 03-AUG-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, nausea, achy everywhere, and feels horrible, and the outcome of couldn''t sleep was not reported. This report was non-serious.


VAERS ID: 1530490 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 182181 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210807973

Write-up: RED SPOT UNDER EYE, TINY RED PERFECTLY ROUND SPOT 1 INCH BELOW LOWER EYELID, THINKS IT WAS A PETECHIAE; This spontaneous report received from a patient concerned a 29 year old female. 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: 182181, and expiry: UNKNOWN) dose was not reported, administered on 03-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the subject experienced red spot under eye, tiny red perfectly round spot 1 inch below lower eyelid, thinks it was a petechiae. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from red spot under eye, tiny red perfectly round spot 1 inch below lower eyelid, thinks it was a petechiae. This report was non-serious.


VAERS ID: 1530495 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chest pain, Ear pain, Influenza like illness, Neck pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Body temperature; Result Unstructured Data: 101 F
CDC Split Type: USJNJFOC20210808102

Write-up: CHEST PAIN; FLU LIKE SYMPTOMS; NECK PAIN; EARS HURT; This spontaneous report received from a parent concerned a 19 year old female. 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, and batch number: 1820095 expiry: UNKNOWN) dose was not reported, administered on 03-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the subject experienced chest pain. On 03-AUG-2021, the subject experienced flu like symptoms. On 03-AUG-2021, the subject experienced neck pain. On 03-AUG-2021, the subject experienced ears hurt. Laboratory data included: Body temperature (NR: not provided) 101 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chest pain, flu like symptoms, neck pain, and ears hurt. This report was non-serious.


VAERS ID: 1530815 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-25
Onset:2021-08-03
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-08-06
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 on 08/03/21
CDC Split Type:

Write-up: patient is fully vaccinated with moderna vaccine, we do not have the lot numbers available at this time patient was exposed to someone with COVID, tested positive on 08/03/21


VAERS ID: 1531207 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-29
Onset:2021-08-03
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Rhinorrhoea, 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: positive for COVID on 8/3/2021
CDC Split Type:

Write-up: we do not have the lot numbers for her vaccinations available. She was advised to e-mail a copy of her COVID vaccination card to primary care provider''s office. she developed a runny nose on 8/3/2021 and tested positive for COVID that same day


VAERS ID: 1531262 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2062A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210805650

Write-up: MIGRAINE HEADACHE; LITTLE DIZZINESS; This spontaneous report received from a consumer concerned a 62 year old female. 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: 2062A21A expiry: UNKNOWN) dose was not reported, administered on 02-AUG-2021 17:30 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the subject experienced migraine headache. On 03-AUG-2021, the subject experienced little dizziness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from little dizziness on 03-AUG-2021, and had not recovered from migraine headache. This report was non-serious.


VAERS ID: 1531266 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Body temperature, Neck pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), 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:
Current Illness: Back pain; Neck pain
Preexisting Conditions: Comments: The patient had no known allergies and did not have any medical conditions.
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Body temperature; Result Unstructured Data: 99.5 F; Test Date: 20210804; Test Name: Body temperature; Result Unstructured Data: 100.5 F
CDC Split Type: USJNJFOC20210807794

Write-up: BODY ACHES; WORSENED BACK PAIN; WORSENED NECK PAIN; FEVER; This spontaneous report received from a patient concerned a 66 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included neck pain, and back pain, and other pre-existing medical conditions included the patient had no known allergies and did not have any medical conditions.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 03-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-AUG-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 99.5 F. On 04-AUG-2021, the subject experienced body aches. On 04-AUG-2021, the subject experienced worsened back pain. On 04-AUG-2021, the subject experienced worsened neck pain. Laboratory data included: Body temperature (NR: not provided) 100.5 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, body aches, worsened back pain, and worsened neck pain. This report was non-serious.


VAERS ID: 1531293 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 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? 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: 1531316 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Hypotension, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Weakness-Medium


VAERS ID: 1531470 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-04-09
Onset:2021-08-03
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Antigen Covid test PCR Covid test
CDC Split Type:

Write-up: 4/9/2021 Had Covid Janssen Vaccination 8/3/2021 Asymptomatic, POC testing, tested Positive for Covid 8/14/21 Potential to return to work


VAERS ID: 1531472 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EW0186 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pollakiuria, Sleep disorder
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: NP Thyroid , Vitamin D3 Balance , Methylcobalamin B-12 , Vitality multivitamin & mineral
Current Illness: none
Preexisting Conditions: sinusitis
Allergies: Levoquin, Monistat
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Frequent urination has resulted from the shot. The first night I got up six times to urinate. The second night it was three times. The third night three times, and every night since then I have to get up two to four times in the night to urinate. Previous to the shot I occasionally would wake up and have to use the bathroom, but usually could sleep all night without getting up. It is almost like a diabetic that must urinate right after drinking liquid.


VAERS ID: 1531484 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-04
Onset:2021-08-03
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID=19/SARS-COV2, PCR 8/5/21 POSIITIVE
CDC Split Type:

Write-up: COVID-19 positive $g14 days post vaccine series.


VAERS ID: 1531509 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

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

Write-up: Received 1st dose Pfizer between 10:00-10:55. Began to feel hot and as if she were going to faint. Had her lay on the floor with feet elevated. Mom stated she has fainted before. Patient remained conscious and alert. Administered ice pack to forehead. Sat her up slowly then walked around. Stated she felt ok. Released to mom at 11:10.


VAERS ID: 1531543 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-23
Onset:2021-08-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein, Full blood count, Hypoaesthesia, Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia, Red blood cell sedimentation rate
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamin daily + probiotic daily
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: ceclor, effexor, zoloft
Diagnostic Lab Data: CBC. ESR, CRP - in progress
CDC Split Type:

Write-up: red swollen hot rt upper arm, 15 cmx 12.5 cm in size, started day 11 after injection, low grade fever (100 deg F), numbness in rt arm 1st day of reaction , each day area of redness worsening


VAERS ID: 1531551 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Immediate post-injection reaction, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: Gabapentin 100mg Capsule TID PRN. No other reported OTC or herbals reported.
Current Illness: None
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left deltoid injection site erythema extending to mid-shaft of humerus. Localized warmth. Occurred immediately after injection per patient.


VAERS ID: 1531599 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / JET

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Facial pain, Hyperhidrosis, Malaise, Pain in extremity, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None, ibuprofen after vaccination due to side effects
Current Illness: Na
Preexisting Conditions: Alcoholic. Now having severe right side pain in arm, chest, hands, thumbs, include fever and sweating, due to the shot.
Allergies: Na
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Wife and husband went on Sunday for 1st Covid shot.. Following day wife was fine husband came home from work very sick, fever, sweating, chest pain, arm pain, facial pain, hands and thumbs in pain. Can''t sleep been happening every day, comes and goes with pain medication (ibuprofen) pain is unbearable, going on day 6.


VAERS ID: 1531643 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-29
Onset:2021-08-03
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Pain
SMQs:

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: Dose 2 date: ANW 01/19/21 #EL3247
CDC Split Type:

Write-up: fatigue, body aches. no missed time from work.


VAERS ID: 1531649 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Head discomfort, Injection site pain, Injection site swelling, Pain
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa based medicine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe soreness and quite a bit of swelling at injection site. Chills and entire body soreness starting around 10pm continuing until through the next day until about 6pm. Head pressure for about two days. Arm soreness and swelling lasted three days. Took Tylenol every four hours from 6pm 8/3/21 until 11pm 8/4/21.


VAERS ID: 1531652 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Immediate post-injection reaction, Musculoskeletal stiffness, Palpitations, Tremor, Vaccination site coldness, Vaccination site pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (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: daily multi vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: immediate pain and cold sensation at vaccine site. Lightheadedness, dizziness, heart palpitations, shakiness and extreme fatigue for 48 hours. Cold sensation at vaccine site has persisted from 8/3 until today 8/6 also have aches and stiffness in my left shoulder, left clavicle area and left scapula area.


VAERS ID: 1531664 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-02-03
Onset:2021-08-03
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, sertoline
Current Illness: none
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: PCR covid test
CDC Split Type:

Write-up: 1/13/2021 Pfizer Covid Vaccine 2/3/2021 Pfizer Covid Vaccine 8/3/2021 ill 8/4/2021 PCR test positive for Covid 8/11/2021 potential to return to work


VAERS ID: 1531680 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 20 mg lexapro
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Irregular vaginal bleeding and vaginal blood clots.


VAERS ID: 1531683 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-31
Onset:2021-08-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Magnetic resonance imaging heart, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: troponin positive 8/3/2021, cardiac MRI 8/4/2021
CDC Split Type:

Write-up: myopericarditis - admitted hospital August 3-5, 2021


VAERS ID: 1531708 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, Secretion discharge
SMQs:, Anaphylactic reaction (broad), 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: Morphine
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Cough, thick mucus, sore throat


VAERS ID: 1531798 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 3 LA / IM

Administered by: Public       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: arrived to walk in clinic. She completed a form as required. She did not present her white immunization card at that time. She marked in two places on form that this was her first dose. She was taken into the clinic to receive the vaccine. While checking the Immunization Registry it was detected that she had already received two doses prior to this visit. White immunization card was updated to reflect that she received 3 doses. Nurse discussed with the concerns and issues surrounding receiving the third dose of the vaccine.


VAERS ID: 1531818 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-29
Onset:2021-08-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C: 1000 mg Vitamin D3: 125mcg Vitamin K2: 100mcg Krill Oil: 500mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ringing in right ear followed by dizziness. No treatment. The ringing in the right ear stays while the dizziness comes and goes.


VAERS ID: 1531864 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-21
Onset:2021-08-03
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough 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: DM2 HTN
Allergies:
Diagnostic Lab Data: SARS-COV-2 PCR test positive 8/4/21
CDC Split Type:

Write-up: Breakthru COVID infection


VAERS ID: 1531866 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH includes hx of severe preeclampsia in the 3rd trimester of pregnancy (2015) and latent TB infection (s/p treatment).
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PMH includes hx of severe preeclampsia in the 3rd trimester of pregnancy (2015) and latent TB infection (s/p treatment). 22mins post vaccination pt c/o difficulty breathing. Pt was given 25mg PO Benadryl @10:26am. Vitals: @10:23 BP 124/83, HR 86, RR 20, SPO2 100% -- $g @10:30 124/83, 76, 15, 100% -- $g @10:45 124/86, 84, 18, 100%. Pt stable and released from vaccination site. Recommended that the pt f/u w/ their healthcare provider, f/u instructions provided.


VAERS ID: 1531973 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-27
Onset:2021-08-03
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / UNK - / -

Administered by: Private       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: U07.1 - COVID-19


VAERS ID: 1531992 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / IM

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

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

Write-up: Pt received 0.5ml Pfizer vaccine when the correct dose is 0.3ml. No adverse symptoms reported by patient or family at this time


VAERS ID: 1532009 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-25
Onset:2021-08-03
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: U07.1 - COVID-19


VAERS ID: 1532013 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-16
Onset:2021-08-03
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: U07.1 - COVID-19


VAERS ID: 1532022 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-08-03
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: U07.1 - Laboratory confirmed diagnosis of COVID-19


VAERS ID: 1532067 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Adenovirus test, Cardiac imaging procedure abnormal, Chest pain, Cytomegalovirus test, Decreased appetite, Echocardiogram abnormal, Electrocardiogram ST segment elevation, Enterovirus test, Epstein-Barr virus test, HIV antibody, Herpes simplex test, Human herpes virus 6 serology, Immunoglobulin therapy, Intensive care, Myalgia, Mycobacterium tuberculosis complex test, Myocarditis, Nausea, Parvovirus B19 test, Pyrexia, Respiratory viral panel, SARS-CoV-2 antibody test, Stool analysis, Ventricular dysfunction, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: No known (limited follow-up, unvaccinated apart from COVID vaccine, per mother had murmur during childhood they were told was benign and didn''t need follow-up, no murmur on exam during hospitalization).
Allergies: No known
Diagnostic Lab Data: Respiratory pathogen panel - negative 8/6 Cardiac MR, TTE suggestive of decreased ventricular function Intial EKG showed diffuse ST elevation, now normalized Remainder of testing pending including: Enterovirus PCR Enterovirus stool study Adenovirus PCR HHV6 PCR CMV PCR CMV IgG/IgM HSV PCR Parvovirus B19 PCR Parvovirus B19 IgG/IgM EBV panel EBV PCR HIV AB Quantiferon TB gold COVID-19 IgG SARS-CoV2 nucleocapsid Ab
CDC Split Type:

Write-up: Patient experienced fever, myalgias, anorexia/nausea/emesis 1d following COVID vaccine, 2d after had chest pain with emesis, presented to ED and was hospitalized with myocarditis. Treated with IVIG, ketorolac, acetaminophen as well as milrinone to support cardiac function. Currently hospitalized in PICU 4d following vaccine administration.


VAERS ID: 1532083 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Nausea, Oropharyngeal pain, Pulmonary congestion, Pyrexia, Streptococcus test negative
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data: Rapid strep, rapid flu 8/6 negative
CDC Split Type:

Write-up: fevers x 3 days started 8/3 up to 101.5, nausea x 3 days, sore throat/congestion x 3 days


VAERS ID: 1532084 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-18
Onset:2021-08-03
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, 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? 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: U07.1 - COVID-19 virus infection breakthrough infection covid


VAERS ID: 1532094 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-01-18
Onset:2021-08-03
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 LA / IM

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

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

Write-up: Tested positive for COVID after being fully vaccinated


VAERS ID: 1532105 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad)

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

Write-up: SHE RECEIVED HER COVID-19 VACCINE ON MONDAY 8/2 AND FELT FINE. TUESDAY, SHE STARTED HAVING INCREASING PAIN UNDER HER LEFT ARM THAT EVENTUALLY SPREAD TO HER UPPER BREAST. IT WAS SWOLLEN AND PAINFUL TO THE POINT THAT SHE SAW A VIRTUAL MD, WHO TOLD HER TO SEE THE PHARMACY SHE WENT TO . I TOLD HER SHE NEEDED TO SEE AN MD IN PERSON AND I WOULD FILE THE APPROPRIATE REPORTS. I GAVE HER THE COUNTERMEASURES INJURY COMPENSATION PROGRAM NUMBER AND WEBSITE TO VISIT. I SPOKE TO HER ON FRIDAY 8/6 AND SHE HAD SEEN AN MD WHO GAVE HER IBUPROFEN AND APAP FOR THE PAIN, BUT DIDN''T WANT HER TO DO ANYTHING TO DECREASE EFFECTIVENESSOF THE VACCINE. THEY SAID IT WAS COVID ARM AND THAT IT WOULD GO AWAY IN A COUPLE OF WEEKS. SHE SAID IT WAS STILL PAINFUL AND SWOLLEN AT THIS POINT.


VAERS ID: 1532127 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-04
Onset:2021-08-03
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laboratory test, No adverse event
SMQs:

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: Scientific laboratory on 8/3 and 8/5/2021
CDC Split Type:

Write-up: Caught during routine testing. No symptoms. Patient feels good.


VAERS ID: 1532152 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Erythema, Headache, Lethargy, Oedema peripheral, Pyrexia, Vomiting, Weight bearing difficulty
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Anastrozole 1 mg daily, children''s multi-vitamin daily
Current Illness: Patient experienced bee sting for first time ever 3-4 days prior (7/30/21 or 7/31/21) to his 2nd COVID vaccine dose. At that time, response was mild & local, stinger removed & mother treated with topical local anesthetic. Bee sting occurred at bottom lateral side of left foot. No other known acute illnesses at that time.
Preexisting Conditions: Premature adrenarche (treated with Anastrozole since March 2021)
Allergies: Latex sensitivity, anaphylaxis was ruled out 4 years ago prior to vaccine, Bee Sting allergy, following second dose of vaccine
Diagnostic Lab Data: No additional tests or labs done.
CDC Split Type:

Write-up: Vomiting & fever over 100.4, but no higher than 101.5. started approximately 16-17 hours later, next morning (8/3/21) after second dose, along with expected headaches, chills, and lethargy . Those symptoms resolved by morning of 8/4/21, but followed with left ankle & foot edema, joint pain, redness, and progressive difficulty weight-bearing as day progressed. This occurred on the same side & body part (left ankle & foot) of bee sting (which occurred on 7/30 or 7/31) prior to receiving second dose on 8/2/21. Mother treated initially at home with Benadryl, ice & elevation with no change in left foot & ankle symptoms, so took patient to ER that evening. There, he received Prednisone plus was instructed to continue Benadryl & add Pepcid AC, as well as a prescription for Epi Pen in case of future bee stings. Infection ruled out. Diagnosis was delayed allergic reaction to bee stings. Patient improving at home with medication. Please note that the emergency physician did not indicate any direct correlation between these two events (patient''s bee sting and subsequent second dose) nor did patient''s pediatrician. Patient''s mother (Reporter) is reporting these symptoms along with sequencing of events, due to unusual delay in allergic response of bee sting, nature of response, and timing with second COVID-19 vaccine dose, and understands this could be purely coincidental. When patient received both COVID-19 doses, he had no known allergies, only latex sensitivity.


VAERS ID: 1532241 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast enlargement, Breast tenderness, Fatigue, Feeling abnormal, Headache, Insomnia, Lymph node pain, Lymphadenopathy, Muscle contractions involuntary, Nausea, Pelvic pain, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lipodystrophy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Sexual dysfunction (broad)

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

Write-up: Fever started 24 hours after shot was administered and lasted for 48 hours. Itching persisted for 48 hours. Unusual muscle contractions for 48 hours along with Insomnia. Headache, nausea and fatigue for 48 hours. Lymph nodes under the arms, breast tissue, left side of neck and bilaterally in groin became swollen and painful and is still persisting after 4 days. I also experienced brain fog, pain in right pelvic region and onset of early period. in addition breasts increased in size and became painful to touch.


VAERS ID: 1532259 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-04
Onset:2021-08-03
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / UN

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: Triamcinolone cream
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: SARS-CoV-2 Antigen positive on 08/06/2021
CDC Split Type:

Write-up: Patient vaccinated for COVID-19 with Janssen/J&J vaccine, and 4 months later tested positive for COVID-19


VAERS ID: 1532269 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-27
Onset:2021-08-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO168 / 2 RA / SYR

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

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

Write-up: Rash & hives on chest & back & some on stomach & legs


VAERS ID: 1532279 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu
Other Medications: Trelogy Albuterol. Lorazepam. Zolif.busprone. a water pill. Creon. Levothyroxine. Metforman. Dicitlen
Current Illness: No
Preexisting Conditions: Asthma Copd Chronic pancreatitis Thyroid Anxiety Diabetes
Allergies: Anything with sulfa. Anything with asperin. Ibeprofen. Benedryl penicillin. amoxicillin morphine fisj. Seafood. Mustard.
Diagnostic Lab Data: Moderna shot
CDC Split Type:

Write-up: The first day nothing every day it has a red spot that keeps getting bigger. It is red and hot and itchy and very painful


VAERS ID: 1532647 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-02-08
Onset:2021-08-03
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / 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: carvedilol, metformin, rosuvastin, empagliflozin, glipizide, ;losartan, aspirin,
Current Illness:
Preexisting Conditions: CAD, HTN, hyperlipidemia
Allergies: lisinopril
Diagnostic Lab Data:
CDC Split Type:

Write-up: tested positive for covid after completing covid vaccine series


VAERS ID: 1532661 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: Sore in roof of mouth, painful like a blister. No treatment; symptom still present


VAERS ID: 1532887 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Tingling and numbness in feet.


VAERS ID: 1533114 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-08-03
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Malaise, 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: positive covid19 PCR test, 8/5/21
CDC Split Type:

Write-up: fully vaccinated (Pfizer, 2/24/21, 3/17/21); symptom onset 8/3/21


VAERS ID: 1533117 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Diarrhoea, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known.
Current Illness: Not known.
Preexisting Conditions: Not known.
Allergies: Not known.
Diagnostic Lab Data: Not known.
CDC Split Type:

Write-up: Patient RETURNED to pharmacy on 08/06/2021 (Friday) concerning reaction to MODERNA IMZ. Patient received MODERNA IMZ on 07/30/2021 (Friday). PT indicates on Tuesday (08/03/2021), he noticed swelling starting under his right armpit. It started out small and has grown larger. At its current state, the swelling is appears to be 1.5 to 2 inches in diameter and raised approximately half an inch. Swelling appears to be sub-dermal. Skin color appears normal and matches surrounding area; does not appear red. Swelling is located under the lower right armpit where the hairline ends. Patient states he had pain in the beginning, however, the pain has subsided. States pain is only minor to an almost unnoticeable intermittent ache. Patient indicates no fever at any time. States no other swelling. States no other obvious signs of reaction. Indicates mild diarrhea that started today, however, states he did change his dietary routine recently and suspects that could be a contributing factor. Patient indicates no difficulty breathing.


VAERS ID: 1533277 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-08-03
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Malaise, 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: positive covid19 PCR test 8/5/21
CDC Split Type:

Write-up: fully vaccinated (Pfizer, 3/17/21, 4/8/21); symptom onset 8/3/21


VAERS ID: 1533287 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: hs troponin peak at $g25,000 ng/L Echo normal
CDC Split Type:

Write-up: Myocarditis - chest pain with significantly elevated troponin.


VAERS ID: 1533687 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fatigue, Headache, Hypoaesthesia, Hypotension, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Hypokalaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Experienced a little headache a few days prior to the vaccination
Preexisting Conditions: Good Health condition
Allergies: Tablet: Co-trimaxazole
Diagnostic Lab Data: I did not undergo any medical test yet
CDC Split Type:

Write-up: After receiving the Jannsen shot around 8:50 am at the morning on Tuesday August 3rd 2021, later within an hour I had a mild pain at my forehead. In addition, I had fatigue, muscle pain, and low blood pressure, and weakness for five days, which slightly got better after the first two days following vaccination day. However, my forehead pain first disappeared from left forehead completely to right forehead. And Today, by the time of writing this report in August 7 early morning I feel less pain and more numbness in my right forehead. However, after morning, now around 11 am, the numbness distributed to my whole right side of my head, and now dizziness also appeared. I searched for Jannsen Vaccine side effects, since I did not see similar symptoms, I felt to report this. I do not know what will happen or how the symptoms will change, and look forward to hearing from you. Thanks


VAERS ID: 1534001 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New Mexico  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Medication error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BNT 162
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210810486

Write-up: MEDICATION ERROR; This spontaneous report received from a health care professional concerned a 43 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, and batch number: 203A21A expiry: 11-SEP-2021) dose was not reported, administered on 03-AUG-2021 for prophylactic vaccination. Concomitant medications included BNT 162 for prophylactic vaccination. On 03-AUG-2021, the subject experienced medication error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of medication error was not reported. This report was non-serious. This case, from the same reporter is linked to 20210810488.


VAERS ID: 1534002 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Mexico  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210810488

Write-up: WRONG VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a 48 year old female. 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 and batch number: 203A21A expiry: 11-SEP-2021) dose was not reported, administered on 03-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the subject experienced wrong vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of wrong vaccine administered was not reported. This report was non-serious. This case, from the same reporter is linked to 20210810486.


VAERS ID: 1534692 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Dyspnoea, Heart rate irregular, Hot flush, Hyperhidrosis, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tachyarrhythmia terms, nonspecific (narrow), Hypoglycaemia (broad)

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

Write-up: Patient reports that after receiving second dose he started having cold-like symptoms, sweating, hot flashes, difficulty breathing and heart racing/fluttering. I recommended he contact his cardiologist regarding the heart palpitations and irregular heartbeat.


VAERS ID: 1534696 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Intermediate headache started after 8 hours taking vaccine. Intermediate nausea started after 24 hours. Intermediate left arm pain after 4 days.


VAERS ID: 1534724 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (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: Excedrin Migraine
Current Illness: None
Preexisting Conditions: Not officially diagnosed, but possible subclinical hypothyroidism based on blood work done in February 2021.
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 30 minutes of receiving the vaccine, on the left side my pinky, ring finger and outer arm started tingling. This is the same side I received the vaccine on. The tingling continued through the night and all day the next day. By August 5th, I had also experienced tingling some in my left calf and thigh and the top of my left foot and also in my right pinky, ring finger and outer arm. The tingling was lessened when I took 600 mg of Ibuprofen. But didn''t go away. I had slight tingling in original fingers and arm on the left side on the morning of August 6th. But then it subsided the rest of the day. As of today, August 7th, I am not experiencing symptoms.


VAERS ID: 1534780 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Skin tightness
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient says she has swelling in her hands, feet and legs. She also states that her right arm felt tight


VAERS ID: 1534884 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast pain, Chills, Fatigue, Groin pain, Lethargy, Lymph node pain, Nasal congestion, Neck pain, Oropharyngeal discomfort, Oropharyngeal pain, Tenderness
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Lipodystrophy (broad), Osteonecrosis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac 10 mg po qd Methylcobalamin 1,000 mcg qd Biotin 1000 mcg qd Iron 29mg po qd Magnesium 235 mg po qd
Current Illness: No significant medical history. Healthy individual.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: On the morning after my vaccine 8/3/21 I woke with arm tenderness, fatigue, lethargy, and pain in lymph nodes in bilateral breast, bilateral groin, and bilateral neck. I self treated by increasing water consumption to 64 oz that day, 400 mg of Ibuprofen bid, and rest. The other symptoms continued and worsened on Wednesday, August 4 I awoke with the above symptoms and also chills, sore throat, and nasal congestion, and white patches in my throat. I treated the same as above and also started on nasal irrigation and Sudafed 30mg bid. The only symptom that has resolved is lymph node pain the others continued.


VAERS ID: 1534938 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-08-03
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: covid after vaccination


VAERS ID: 1534964 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Headache
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Same with all vaccines the last 15 yrs or so. Tdap, flu, hep,.... This one was forced by my job with no exemptions given.
Other Medications: Hctz 10mg Fish oil Potassium citrate
Current Illness: None
Preexisting Conditions: Kidney stones Hyperlipidemia
Allergies: Laytex
Diagnostic Lab Data: None asked for. Seeing Dr Monday in telehealth. Can''t afford recommended er or urgent care and thousands of dollars in testing at the er for concerns from a free shot.
CDC Split Type:

Write-up: Headache, Uncontrollable stomach cramping and diarrhea (on the 4th day) seeing dietician and physician for symptoms.


VAERS ID: 1534986 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-18
Onset:2021-08-03
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: covid pos after vaccination


VAERS ID: 1534994 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Hyperhidrosis, Hypotension, Hypotonia, Loss of consciousness, Nausea, Paraesthesia, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cyclobenzaprine, Ibuprofen, Fluconazole, Baclofen, Gabapentin, Testosterone Injections
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood pressure was checked and the EMS was called.
CDC Split Type:

Write-up: Immediately after the vaccination the patient began to feel lightheaded and dizzy and reported feeling tingly. The patient was very sweaty and clammy and did seem to pass out for a few moments. She slumped in her chair and was unresponsive for about 2 seconds. She then was responsive again and reported feeling nauseous and sweaty. Her blood pressure was obtained which was 80 / roughly 40 (hard to determine). The patient stayed responsive and did not pass out again. Due to the patient''s low blood pressure EMS was called. EMS came to check the patient out and she declined further treatment in the emergency room.


VAERS ID: 1534997 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-01
Onset:2021-08-03
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Rotator cuff syndrome, Stress
SMQs:, Tendinopathies and ligament disorders (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxone 88mcg, omperazole 20mg, b12 supplement daily, 2000 iu vitamin d supplement daily
Current Illness:
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: visual diagnosis by dermatologist
CDC Split Type:

Write-up: I got shingles on my right arm. This was coincidental with a torn rotator cuff (right shoulder) and stress


VAERS ID: 1534999 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, 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: None
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient made an appointment for a second dose for her Pfizer vaccine. The patient received the first dose on 7/21/2021, then received her second dose on 8/3/2021. Patient did not report any adverse reactions at this time.


VAERS ID: 1535092 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)

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

Write-up: Patient came to pharmacy to report a rash on right arm in area where she had the Covid-Pfizer vaccine. She takes a daily antihistamine for allergies and she had tried a cold compress on the rash. It has not improved.


VAERS ID: 1535128 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Confusional state, Disorganised speech, Dreamy state, Epistaxis, Eye pain, Fear, Feeling abnormal, Headache, Metamorphopsia, Migraine, Oropharyngeal pain, Pyrexia, Rash, Rash pruritic, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Retinal disorders (narrow), Generalised convulsive seizures following immunisation (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: There are no tests for adverse reactions to this vaccine as it is only a few months old. At least I was not offered any if there is guidance being given on how to test for this. Good luck in your research- I truly hope this information helps you to help others and thank you for all of the work that you are doing to perfect these vaccines!
CDC Split Type:

Write-up: Tuesday, August 3, 2021: 5:18pm: Received Pfizer mRNA vaccine. Ok for about 15 minutes and started to leave pharmacy but there was a faint but strange ?dreamlike? feeling when I stood up and there were some distortions of light so I stayed for another maybe 20 minutes until I knew I was safe to drive. 7:15pm: I experienced the first migraine of my life, it actually caused me to vomit, and the first nose bleed of my life approximately an hour after the shot. I had to lie down with a dark wet rage on my face so it?s hard to say the exact time. I?m 43 so I don?t think it was a coincidence. After I vomited, I felt well enough to drive. 8:24pm: Arrived at the ER so they could check me and analyze what was happening with the nose bleed. They took my vitals and admitted me but unfortunately, due to the outbreak, there were over 100 people in front of me and it was the middle of the night so after several hours I had to go home and go to bed so I was finally able to go to sleep in the wee hours of the morning. Wednesday, August 4, 2021: Woke up early scratching a rash on my right ankle. Had a fever, sore throat and a headache behind my eyes all day and a lot of confusion, just felt really confused and out of it all day long? like I had dementia or Alzheimer?s or something- very scary. I am not back to myself (for the most part) but at times I have a strange confusion and jumble my words. I am now very afraid of the second Pfizer shot because I CANNOT get stuck like this. I have scheduled an appt with a neurologist to help me decide if I should proceed with shot 2 or go to the Johnson and Johnson shot though there are suggestions that you should not take two different shot brands. I have always been healthy. I do not use drugs, don''t smoke, rarely have a drink of alcohol (if I do never more than 2 and I only drink a few times a year at social events). The only medical malady I''ve had is 10 years ago I had a disorder of pregnancy called Hyperemesis Gravidarum. I know that it is a rare disorder but it is unexplainable so perhaps there is a connection between individuals who get hyperemesis and individuals who react strongly to the vaccine. I hope this all helps.


VAERS ID: 1535149 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Axillary pain, Chest pain, Fatigue, Heart rate increased, Lymphadenopathy, Pain in extremity, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ocella birth control, claritin
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: Latex, erythromycin
Diagnostic Lab Data: N/A don''t have extra cash to be going to urgent care for someone to tell me to take Iboprofen and rest but I strongly considered it on August 3rd when my arm and chest were hurting with resting heart rate 103
CDC Split Type:

Write-up: It was not just a "sore arm" it felt like I was stabbed with a knife through my arm into my armpit Swollen/painful lymph nodes under left arm which have decreased gradually over the week but still present Rapid resting heart rate between 90-100bmp Fatigue-needing a nap daily persists a week later Vivid dreams


VAERS ID: 1535177 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 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-


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