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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 285 out of 7,116

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VAERS ID: 1535233 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-04
Onset:2021-08-03
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / UNK - / -

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

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

Write-up: numbness on left side and had a stroke work up


VAERS ID: 1535237 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-13
Onset:2021-08-03
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Chest pain, Dyspnoea, Heart rate increased, Heart rate irregular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

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

Write-up: Patient presents to hospital with rapid irregular heart beat, shortness of breath, chest pain. Patient diagnosed with new A Fib. PCP office 2 weeks prior reports no rapid irregular heart beat or cardiac abnormalities for patient.


VAERS ID: 1535242 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-12
Onset:2021-08-03
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myocardial infarction, Atrial fibrillation, Chest pain, Computerised tomogram thorax abnormal, Heart rate irregular, Pulmonary mass
SMQs:, Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

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

Write-up: Patient reported she had Moderna vaccines on 2/12/21 and 3/12/21 but does not have her card for Lot numbers. She came to hospital for uncontrolled a fib, irregular heart rate, chest pain. CAT scan revealed multiple spiculated masses in right lung that were not known previously. Pt also found to have NSTEMI.


VAERS ID: 1535277 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Florida  
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 - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram, Fatigue, Fibrin D dimer, Increased appetite, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: EKG, chest x-ray and D-Dimmer blood work
CDC Split Type:

Write-up: Increased heart rate. Fluctuations of heart rate. Fatigue. Slight pressure in chest and left pectoral area at times.


VAERS ID: 1535320 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: South Dakota  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid medication,pregnenolone, vitamin D, NAC, zinc, olive leaf, oregano oil, liver support, multivitamin, ashwaganda
Current Illness: Hypothyroidism, PTSD
Preexisting Conditions: Immuno compromised Post sepsis syndrome, lyme Disease, hypothyroidism, PTSD, Epstein bar virus
Allergies: Metronidazole, eyebright, Cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: Felt electric shock down arm into a little finger immediately plus painful injection. Within the next hour felt product seep into left side of head and ear, and into left shoulder blade. Required Tylenol for the next 48 hours with 8/10 Pain scale. Five days later I still have arm pain, pain in the left side of my head and ear and left shoulder blade 2/10 pain scale. Mild fatigue for 48 hours.


VAERS ID: 1535334 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-28
Onset:2021-08-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Illness, Mobility decreased, Sensitive skin
SMQs:, Parkinson-like events (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: 50 mcg Levothyroxin, 1mg/week Ozempic, 20mg every other day Prozac, 15 mg every other day Cymbalta, multivitamin daily, ceritrizine daily
Current Illness: Ear infection about 3 weeks prior
Preexisting Conditions: Diabetes, fibromyalgia, hypothyroidism
Allergies: Penicillin, most opioid pain meds
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection arm restricted mobility for 2 days after shot, fatigue and general feeling of illness day after shot, hypersensitivity of skin on back, shoulders, and underarms that started a week after the injection


VAERS ID: 1535340 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-15
Onset:2021-08-03
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN ? / 1 RA / SYR

Administered by: Other       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: 4 months later? I am very sick with Covid, even though I had the Johnson and Johnson vaccine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: None till 4 months later, I note have Covid, synonyms and tested positive


VAERS ID: 1535436 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-24
Onset:2021-08-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Ear discomfort, Ear pain, Facial paralysis, Headache, Hemiplegia, Hypoaesthesia, Ocular discomfort
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Sexual dysfunction (broad)

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

Write-up: Facial paralysis on the left side of the face. Numbness on the left side of the face. Pressure under the left ear, eye, chin, and can''t smile 100%. Hear heartbeat in the left ear. All those happened on 8/3/2021. I went to the urgent care and they advise to go to the emergency. I went to the emergency and they said they are not 100% sure what this is but I might got bell''s palsy. No treatment were given and doctor advised to watch symptoms. On 8/7/2021 I had bad headache on the right side and a strong pain under the right side of the ear.


VAERS ID: 1535470 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-19
Onset:2021-08-03
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 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 8/6/21
CDC Split Type:

Write-up: fully vaccinated (moderna, 3/22/21, 4/19/21), onset of symptoms 8/3/21


VAERS ID: 1535512 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-21
Onset:2021-08-03
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal X-ray, Computerised tomogram abdomen, Renal mass, Ultrasound abdomen, Urinary tract inflammation
SMQs:

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

Write-up: Severe swelling of right kidney. In the course if diagnosing this problem, they discovered a 2.6X2.5 cm mass on left ovary which will require further follow up.


VAERS ID: 1535540 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-06
Onset:2021-08-03
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 developed a cough on 8/3/2021. Tested positive for COVID on 8/5/2021.


VAERS ID: 1535605 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arizona  
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 - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa antibiotics
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dizziness about 15 minutes after. Hard time swallowing 20 minutes after. Both cleared up in 24 hours. 5 days after vaccine random dizziness occurs and blurry vision started.


VAERS ID: 1535664 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 1 LA / IM

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

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash Generalized-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium


VAERS ID: 1535892 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-20
Onset:2021-08-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 AR / SYR
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: She received Janssen dose on 7/20/21 and Noticed s/s 8/5/21 tested positive covid 8/6/21


VAERS ID: 1535908 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O26D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site rash, Injection site warmth, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), 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: Multivitamin, fish oil, probiotic, turkey tail
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Itchy solid red rash on left breast started in the evening two days after receiving vaccine. The rash was hot to the touch, approximately 4 inches in diameter, and slowly went away. Once it went away, which was one week after getting the vaccine, I got a similar itchy red rash, approximately 2.5 inches in diameter, at the injection site on my left arm. This rash was extremely itchy for about 10 minutes. It felt hot, swollen, and hard, and seems to be slowly subsiding.


VAERS ID: 1535939 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-26
Onset:2021-08-03
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

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

Write-up: SOB, swelling in his lower extremities.


VAERS ID: 1535956 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Palpitations, Paraesthesia, Pruritus, Tinnitus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: none - don''t eat wheat due to being celiac is all
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shot given 2:30 Tuesday afternoon, that evening around 5:3-6:00 severe ringing of ears, Wednesday tingling of the bottom of the feet & ringing of ears, Thursday tingling, nerve sensation,itching/spark feeling sensations in feet, ankles, calves, thighs, some in hands & still tinnitus, heart feels loud/pounding, Friday all this progresses to severe heart pounding worse, nerve sensation and ears all worse slept none Friday night due to this. Saturday tried to get into doc, not available, so I starting upping my B vitamins, Vit C and Alpha Lipoic Acid all which help support the nerves. Saturday I could sleep but still have nerve sensations, ears calmed some, heart calmed some-Sunday random nerve sensations/numbness tingling itching better but still here. Same for today Monday Aug 9. NONE of this was present before taking this Pfizer Covid vaccine. I''ve heard numerous reports of this yet it is NOT on their list of side effects. I''m unsure why a "safe" vaccine everyone is told to take would effect someone''s nervous system like this HIGHLY concerning and needs to be reported to public.


VAERS ID: 1536057 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose decreased, Continuous glucose monitoring, Diarrhoea, Excessive eye blinking, Hypoglycaemia, Neck pain, Tic, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (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: Insulin Seroquel Celexa Lamotrigine Methylfolate
Current Illness: Type 1 diabetes Mood disorder
Preexisting Conditions: Type 1 diabetes Mood disorder
Allergies: None known
Diagnostic Lab Data: Continuous CBG monitoring, CBG has been as low as 43
CDC Split Type:

Write-up: Vomited the evening after getting the vaccine. Has had daily diarrhea since vaccine. Watery stools dailyl. No normal stools since Pt is insulin dependent diabetic, having hypoglycemic episodes. CBG has been as low as 43, needed glucose She has also had an increase in tics Neck pain Neck tic, urge to turn neck to the side Eye blinking tic


VAERS ID: 1536084 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-07-26
Onset:2021-08-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Obstructive Sleep Apnea and Other (Blood transfusion, irregular heart rate, multiple trauma at age 22, obesity)
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hopsitalization--patient now fully vaccinated with Janssen


VAERS ID: 1536092 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blister, Burning sensation, Erythema, Herpes zoster, Skin infection, Skin irritation, Swelling face
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 50mg, Vitamin B complex, Vitamin D
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Four days after the shot, I woke up with a burning sensation under my eye with some redness. The next day I woke up and it was very red. The third day I work up with some minor swelling and tiny blisters. The following day my under eye was swollen, very red, and irritated. The blisters were crusty but not scabbed. I went to Urgent care and the provider there thought it was Shingles but wasn?t sure. Directed me to the ER because they have an Ophthalmologist on staff. The ER doctor confirmed it was shingles and it had not spread to my eye. The doctor also thought I had a skin infection also and that was causing the swelling. I was sent home with antiviral medication and also and antibiotic.


VAERS ID: 1536106 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Fever, headache, ache , whole busy heard. Generalized lymph node on left side of my neck


VAERS ID: 1536121 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

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

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

Write-up: Not sure if the vaccine caused these effects, but I have a very itchy rash all over my body in different parts. Lower stomach, leg, both arms, neck. Very reminiscent of poison ivy but I don''t recall contacting any plants over the past 3 weeks.


VAERS ID: 1536149 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-01-15
Onset:2021-08-03
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID test
CDC Split Type:

Write-up: Breakthrough COVID case


VAERS ID: 1536205 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-28
Onset:2021-08-03
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Arthralgia, Computerised tomogram head normal, Diplopia, Dizziness, Dysarthria, Dysstasia, Immunoglobulin therapy, Inappropriate schedule of product administration, Lumbar puncture, Muscular weakness, Slow speech
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Arthritis (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen, alprazolam, aspirin, docusate, etodolac, furosemide, hydralazine, irbesartan, nitroglycerin, potassium
Current Illness: Urinary tract infection
Preexisting Conditions: HTN, CAD, neurogenic bladder
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 85 y.o. male who presented to the ER on 8/5/2021 complaining of dizziness, dysarthria, double vision and lower extremity weakness. Daughter states that symptoms started 2 days ago and he has just become progressively weaker. Patient currently not able to stand on his own when typically he is able to ambulate with a walker. Speech has become progressively "slower". Patient having difficulty with word finding. He denies any associated nausea, vomiting, dyspnea, chest or abdominal pain. He does have a history of arthritis and currently is having some joint pain. CT of the head was done showed no acute intracranial event. Patient was seen by teleneurology here and neurologist was concerned that patient may be developing Guillain-Barre syndrome. Patient transferred to higher level of care for further care including the need for an LP and IVIG. Patient received Pfizer COVID vaccine on 3/21/2021 (first dose) and second dose on 6/28/2021. At the time of submission the patient is still hospitalized and on Day 4/5 of IVIG.


VAERS ID: 1536228 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Lymph node pain, Lymphadenopathy, Musculoskeletal chest pain, Tenderness
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: When he woke up On August 3rd, he was in pain. He had a sharp pain in his underarm and ribs. I looked and saw swelling under his armpit which was the same arm he received the shot. I felt the swelling, his lymph nodes were swollen and hurt him when I touched it. I advised him to stop practicing for football because I thought he just pulled a muscle or something. On the next day, it was swollen more, and I took him to the doctor. The doctor saw how much pain he was in and gave him an examination. She made him lay down, tried to touch the area and saw that he was in excruciating pain. She determined that his lymph node was swollen. She advised me to keep an eye on him and if it got worse to bring him back immediately. Advised him to take Tylenol and use a cold compress on the area. He is no longer having pain, but his armpit is still swollen.


VAERS ID: 1536243 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Oral pruritus, Pruritus, Skin tightness, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Clinic Nurse Reports: Pt received covid vaccine and had to wait 30 min due to anaphlyaxis with shellfish. Toward the end of observation, pt began to complain of itching in mouth, ear, and throat, along with tightness around mouth. Obtained VS, called EMS, and administered 1mL of diphenhydramine.


VAERS ID: 1536280 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-22
Onset:2021-08-03
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL32049 / 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: 08/08/21 COVID-19/SARS-COV2, PCR POSITIVE
CDC Split Type:

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


VAERS ID: 1536328 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-16
Onset:2021-08-03
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Azelstine 137 MCG/nasal spray 1 SID, Flovent diskus 100 MCG/actuation powder for inhalation BID, Lamotrigine 100 mg disintegrating tablets SID, Zysol for allergies SID, Magnesium, Nasonex one spray SID, Monteluskast 10mg. SID, Smarty Pant
Current Illness: None
Preexisting Conditions: Sarcoid diagnosed 1994, Arthritis, Degenerative Disc Disease, Migraines
Allergies: any opiods, latex, some adhesives and bandages
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives, face, neck, sholders, arms, knees


VAERS ID: 1536348 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Hypoaesthesia, Impaired work ability, Malaise, Pain
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Sexual dysfunction (broad)

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

Write-up: I had a patient who received a COVID vaccine last Monday come in complaining about lingering side effects. His arm was still bruised at the shoulder and near the triceps area and he said his arm sometimes feels numb. He showed me the spot where he got vaccinated on his arm and it did look to be the front lower part of his deltoid. I told him that bruising does sometimes happen, but these issues do normally resolve fairly quickly and that the numbness seemed unusual to me. I did tell him that the spot he was vaccinated looked a little low so it''s possible that a tendon or nerve was hit, which is causing the pain. He missed 2 days of work last week, but it sounded like that was due to feeling ill after getting vaccinated. He said that he was very sick and I told him that sometimes happens. He also said the pain is bad and seems to be not improving or getting worse. He is concerned that this pain will affect his work and cause him to miss more time at work and he wanted to know what to do. He said he called us last week and we recommended Tylenol and Benadryl. I asked him if he had tried ice and he hadn''t so I recommended it and said if the pain seems like it''s getting worse, he should follow up with his doctor or go to a convenient/urgent care to get it checked out. When I called him back, I also recommended alternating Tylenol with ibuprofen and using heat along with ice.


VAERS ID: 1536389 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pt reports that 4 hrs post vaccination she experienced elevated HR, severe anxiety, next day swollen eyes and face, went to ER,
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Severe allergy to bee stings, carries Epi-pen; mild allergy to cats & pollen; Allergic reaction to 1st dose Moderna
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received Janssen dose, after receiving 1 Moderna dose, that she had an allergic reaction to. Per CDC guidelines, this is a reportable event because mixed dose series are not FDA-authorized at this time. Patient was observed for 30 minutes post vaccination, due to Hx severe allergies, and allergic reaction to prior dose of COVID vaccine (mRNA). No adverse reactions noted or reported.


VAERS ID: 1536462 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-28
Onset:2021-08-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, Herpes zoster, Lymph node pain, Lymphadenopathy, Pain of skin, Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: crestor, amlodipine
Current Illness: none
Preexisting Conditions: HTN, hyperlipidemia, OSA
Allergies: aspirin, penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to office on 8/4/21 with complaint of feeling tender along rt scalp/head with tender rt neck glands and a feeling of pressure in rt ear. On exam, she had small, tender mobile post auricular and occipital lymphadenopathy. Patient returned to office 8/9/21 with tender, eryth, vesicular eruption along rt forehead/upper rt eyelid dermatomal region consistent with shingles. She was treated with antiviral


VAERS ID: 1536544 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-01-19
Onset:2021-08-03
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: COVID 19 test done at facility
CDC Split Type:

Write-up: positive COVID 19 result


VAERS ID: 1536632 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 3 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Laboratory test abnormal
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: No data available
CDC Split Type:

Write-up: Patient was followed at medical center and screening prefomed there. Confirmed. No problems 8/9/2021


VAERS ID: 1537132 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / IM

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

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

Write-up: Severe hives on right side of face and all over the body.


VAERS ID: 1537806 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-11
Onset:2021-08-03
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: idiopathic urticaria
Allergies: none
Diagnostic Lab Data: PCR 8/6/21
CDC Split Type:

Write-up: developed COVID disease 8/3/21


VAERS ID: 1540341 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Burning in my left forearm 15 minutes after injection. The next day the burning spread through out my body. 3 days after the injection excessive sweating. The burning is muscular.


VAERS ID: 1540342 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I''m having an itch, arm is feeling hot, and have a lump all on my right arm.


VAERS ID: 1540419 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis, Erythema, Injection site erythema, Injection site pain, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril 10mg tab daily,
Current Illness:
Preexisting Conditions: HTN
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received second Moderna vaccine on 8/3 and on 8/4 developed redness and pain at the injection site. She presented to our ER on 8/8 c/o arm being red, swollen and painful. She was given 1gm ancef IM and d/c with tylenol #3 and bactrim rx. She returned to the ER on 8/9/21 with increased swelling, pain and redness concerning for cellulitis. She was given fluids, zosyn and admitted to med surg for observation with diagnosis of cellulitis in the left upper arm.


VAERS ID: 1540439 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-19
Onset:2021-08-03
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension, Hypothyroidism
Allergies:
Diagnostic Lab Data: Covid 19 Viral Testing Antigen
CDC Split Type:

Write-up: Tested positive on 8/03/2021


VAERS ID: 1540529 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature decreased, Fatigue, Headache, Heart rate increased, Hypersensitivity, Peripheral swelling, Rash, Rash erythematous
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Vitamin D, B
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: The arm was swollen for 2 full days, rapid heartbeat during the first night, body temperature up to 37.4 for 2 days, fatigue for 7 days, allergic reaction on the second day, headache for 3 days, a red rash appeared on the face on the second day (probably vasculitis), getting tired quickly.


VAERS ID: 1540597 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-12
Onset:2021-08-03
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Robitussin, robaxin, prilosec, xarelto, fioricet, albuterol
Current Illness: History of DVT, Leukocytosis,
Preexisting Conditions:
Allergies: gabapentin, codeine
Diagnostic Lab Data: Tested positive 8/3/2021
CDC Split Type:

Write-up: Came to EC for malaise, fatigue, weakness


VAERS ID: 1540614 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RA10893 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Heart rate increased, Heart rate irregular, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness: None
Preexisting Conditions: Postural orthostatic tachycardia syndrome Asthma
Allergies: Environmental
Diagnostic Lab Data: I have an appointment scheduled to check labs on 8/12
CDC Split Type:

Write-up: 8/4, 8/5, 08/9: rapid irregular heart rate as high as 140 for periods lasting around 1-2mins, chest pain, sweating, light headed ness, and slight nausea


VAERS ID: 1540620 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Exposure to extreme temperature, Injection site pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluticasone/salmeterol, albuterol mdi, simvastatin 40mg, duoneb, pantoprazole, meloxicam, magnesium oxide, vitamin d, doxycycline
Current Illness: unknown
Preexisting Conditions: asthma, gerd,arthritis
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling/redness/heat/pain at site of injection


VAERS ID: 1540629 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-02
Onset:2021-08-03
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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

Write-up: Severe cough, SOB and pneumonia.


VAERS ID: 1540767 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-08-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Constipation, Diarrhoea, Fatigue, Migraine, Nausea, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (broad)

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

Write-up: 7 days post vaccine I had severe nausea and extreme fatigue followed by migraines. The nausea came on suddenly and the fatigue / migraines followed about an hour later. I had constipation with some loose stools on days 10&11. These symptoms lasted for almost 5 full days. I hit my peak ovulation day on day 9 or 10 after receiving the shot, so the symptoms may or may not be related. I have NEVER had symptoms of ovulation other than occasional breast sensitivity. I have not been exposed to anyone with COVID, work from home, etc. and took 2 COVID tests to be sure that wasn?t it, and they both came back negative. No other symptoms (ie no runny nose, cough, fever, etc.)


VAERS ID: 1540781 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-27
Onset:2021-08-03
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / 2 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chills, Fatigue, Headache, Malaise, Myalgia, Pyrexia, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen , Lisinopril, prednisone, Metformin
Current Illness: none
Preexisting Conditions: Diabetes, Hypertension
Allergies: Lopermide
Diagnostic Lab Data: Covid-19 SCR (SRL)
CDC Split Type:

Write-up: Patient starting filling ill on 08/03/2021 with fever, chills, muscle aches, runny nose, loss of taste and smell, headache and fatigue.


VAERS ID: 1540934 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-25
Onset:2021-08-03
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 - / -

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1540965 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / UNK - / IM

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

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

Write-up: Patient received a Moderna vaccine on 08/03/2021 and upon entry into the system; it was discovered that he''d previously received another branded vaccine: Pfizer on 04/30/2021


VAERS ID: 1540987 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 3 RA / IM

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

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

Write-up: Patient received a 3rd dose of Moderna. 1st dose on 1/4/21, 2nd dose on 2/1/21, and a 3rd dose on 8/3/21.


VAERS ID: 1540998 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-01-06
Onset:2021-08-03
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5370 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Head discomfort, Headache, Influenza A virus test negative, Influenza B virus test, Pain, 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: Hypertension
Allergies: NKDA
Diagnostic Lab Data: 081021: COVID-19 Abbott ID NOW (+), Influenza A/B both (-)
CDC Split Type:

Write-up: Pfizer COVID vaccine EUA: Fully vaccinated patient presented with a 1-day history of body aches, head pressure and headache


VAERS ID: 1541000 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Pt reported feeling sick at time of vaccination
Preexisting Conditions: unknown
Allergies: none noted
Diagnostic Lab Data: unknown; patient did not provide a working contact phone
CDC Split Type:

Write-up: Pt received two different branded vaccines. Pt received Pfizer on 07/22 and Janssen on 08/03/2021


VAERS ID: 1541008 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Flushing, Nervousness
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Pt. c/o of feeling flushed and lightheaded. Pt reports being "very nervous" before the vaccine and that she has had anxiety attacks in the past. Pt. waited an additional 30 minutes and stated she was feeling better. Pt dc'' d home.


VAERS ID: 1541064 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Nausea, Pain, 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: ProAir HFA Spiriva Klonopin
Current Illness: Arthritis COPD
Preexisting Conditions: Arthritis and COPD
Allergies: Sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: low grade fever, vomit, nausea, body aches


VAERS ID: 1541082 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-08-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Metabolic function test, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBC, CMP on 8/9/21
CDC Split Type:

Write-up: 12 year old female who presents for rash from pfizer vaccine, 2nd dose 31st July, rash started Aug 3rd, started on arms, spread to trunk and legs,. Minimal face involvement, no tongue lip or mouth involvement


VAERS ID: 1541827 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-20
Onset:2021-08-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Menstrual disorder, Menstruation delayed
SMQs:, 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: N/a
Current Illness: None. Was positive for covid antibodies.
Preexisting Conditions: None
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I experienced a 5 day delay in my menstrual period. I regularly track my cycle. My menstruation was different in amount and appearance. I experienced unusual cramping in the middle of the cycle without spotting. My cycle is always 25 days. My cycle remained 25 days while working covid icu, doing rn travel contracts, loss of my parent, having covid, having flu shot, and going on and off other prescription medications. I have yet to see what will happen next and with subsequent cycles.


VAERS ID: 1542113 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Muscle spasms, SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Dystonia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210815211

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID 19 INFECTION; LEG CRAMPS; This spontaneous report received from a patient concerned a patient of unspecified gender, 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 and Expiry: Unknown) dose was not reported, 1 total administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-AUG-2021, the patient tested positive for Coronavirus disease (COVID-19), (suspected clinical vaccination failure, suspected covid-19 infection). At the time of the report the patient still had been feeling very sick for the last 5 days. The symptoms include leg cramps, chills, chest tightness, coughing and extremely tired, the breathing felt okay. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection, and leg cramps, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0.20210815211-covid-19 vaccine ad26.cov2.s -suspected clinical vaccination failure . This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1544682 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091P21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Lymphadenopathy, Pain, Pain in extremity
SMQs:, 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: Buproprion
Current Illness: None
Preexisting Conditions: Anxiety, panic, agoraphobia, ptsd
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sever pain in arm. Next day aches, severe pain left side. Lymph node in armpit was bigger than a golf ball. The enlarged node lasted 4 days. Chills would not stop for 3 days.


VAERS ID: 1544880 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-18
Onset:2021-08-03
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B210 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Condition aggravated, Herpes zoster, Rash, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: burning sensation down right side of neck. Blistery rash on right side of upper torso. Self diagnosis: Shingles. FYI, I also had Shingles when I was 22 years old. This is my second occurrence of the disease


VAERS ID: 1544981 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Inappropriate schedule of product administration, Nausea, Pain, Vaccination site pain, Vaccine positive rechallenge, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First dose of Pfizer vaccine - Same side effects as second dose - 62 yrs.old , 4/13/21, COVID Pfizer received.
Other Medications: Atenolol - 50mg Wellbutrin -75mg Zoloft - 75mg Ecotrin - 325mg Vitamin D3 - 2000 IU Excedrin Tension - when needed
Current Illness: none
Preexisting Conditions: Migraine
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fatigue, weakness, body aches ,nausea, vomiting ,chills, pain in left arm vaccination spot and shoulder. Adverse effects were present for 8 days . Fatigue, body aches and pain in left shoulder and arm still present. Taking OTC medications for pain and Pedialyte for hydration due to vomiting.


VAERS ID: 1545021 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Dyspnoea, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG and bloodwork- 08/05/2021
CDC Split Type:

Write-up: Shortness of breath and chest pain. The shortness of breath resolved fairly quickly, but the chest pain is still ongoing.


VAERS ID: 1545040 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-12
Onset:2021-08-03
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Dyspnoea exertional, Oxygen saturation decreased, Respiratory rate increased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) tablet 500 mg 500 mg Oral Q6H PRN Or ? acetaminophen (TYLENOL) tablet 1,000 mg 1,000 mg Oral Q6H PRN ? albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 90 mcg inhaler (60 dose canister) 2 puff Inha
Current Illness: None known
Preexisting Conditions: CAD HTN
Allergies: Hydrocodone Ace Inhibitors
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 93 y.o. male who presented with cough, weakness. PMHx of NSTEMI, CHF, CAD, HTN, HL. 2 days ago, patient started experiencing a dry cough. Felt weak in the afternoon and dyspneic on exertion. Visiting nurse checked him and noted increased respiratory rate and low oxygen (low 90s). Son prompted patient to go to ED for evaluation. In the ED, he tested positive for COVID-19. Initial O2 sat was 94% on room air, but trended down to 88%, patient was placed on 2L oxygen. Denies known COVID exposure


VAERS ID: 1545104 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-30
Onset:2021-08-03
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ 25MG, INSULIN ASPART, AUGMENTIN, LEVEMIR, LEVAQUIN, GABAPENTIN, STABLE GI, LISINOPRIL, METOPROL 25MG, METFORMIN 1000MG LIPITOR 40MG, ASA 81MG, AMLODIPINE 5MG MIRALAX, MELATONIN 3MG NIFEREX 150, TYLENOL 325MG,
Current Illness:
Preexisting Conditions: MORBID OBESITY, SKIN INFECTION, DMII, SEPSIS, AKF, MAJ DEPRESSION, HYPERLIPIDEMIA,
Allergies: KNA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: RESIDENT INDICATED THIS WAS HIS 1ST COVID DOSE, WAS NOT IN PASIIS PRIOR. UPON ENTERING WHAT WAS THOUGHT TO BE THE 1ST DOSE, THEIR APPEARED A PREVIOUS 1ST DOSE OF PFIZER BY ANOTHER PROVIDER


VAERS ID: 1545182 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse, pulmicort
Current Illness: None
Preexisting Conditions:
Allergies: Peanuts tree nuts garlic onion blue dye penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started having trouble breathing within 3 minutes, left Walgreens and went to Urgent Care, received epipin shot. Then went to ER and received benedryl, steroids and breathing treatment. Received script for prednisone for 4 days. It is a week later and still hard to breathe.


VAERS ID: 1545309 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site swelling, Injection site warmth, Nasopharyngitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic 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)

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: Allergic reaction including Anaphylaxis to the flu shot, measles, mumps vaccine.
Other Medications: Taltz, Ibuprofen, Zyrtec
Current Illness: Seasonal Allergies
Preexisting Conditions: Asthma, Psoriatic Arthritis.
Allergies: Allergy to Peanuts, Egg-based Immunizations
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Day 1-2: injection Site Pain. Day 3-current: Low grade fever, cold like symptoms. Day 10-current: swelling at injection site, pain at injection site. Injection site is hot to the touch.


VAERS ID: 1545434 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Lymphadenopathy, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Sickly feeling for a couple of days after flu vaccine. Last fall also my lymph node in arm pit on injection side was swollen. S
Other Medications: Benazepril HCL 20mg 1xday Vitamin D 2000 IU 1xday Multivitamin 1xday Mupirocin 2% ointment 2xday
Current Illness: No illness. Laceration on leg.
Preexisting Conditions: High blood pressure Chronic kidney disease
Allergies: Neoprene
Diagnostic Lab Data: None
CDC Split Type:

Write-up: High fever despite having taken acetaminophen (103.1): Called doctor''s office. Nurse told me to alternate between ibuprofen & acetaminophen every 4 hours. Fever was still hard to break so I also did calf wraps, cold washcloth on forehead etc. Fever finally lowered sometime in the evening of 08/03/2021. I continued to have intermittent fevers on 8/4 and 8/5. Chills - stopped when fever stopped Muscle aches Headache for 3 days Pain at injection site for about 1 week Swollen lymph node in arm pit on injection side for about 1 week Swollen supraclavicular lymph node on injection side for about 1 week


VAERS ID: 1545447 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-25
Onset:2021-08-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Pain in extremity, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: Covid PCR test - positive - August 5th 2021
CDC Split Type: vsafe

Write-up: After the shot itself he just had a sore arm for two days and then on Tuesday the 3rd of August in the evening and Wednesday the 4th he had congestion. So we did an over the counter Covid test which was positive and we called the pediatrician and got a PCR test as well. On Friday he continued with his symtoms and really has been in isolation since the 6th. The symptoms were improving by the 7th or 8th and he just has some lingering congestion still.


VAERS ID: 1545587 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-23
Onset:2021-08-03
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest tube insertion, Fall, Pneumothorax traumatic, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Accidents and injuries (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Breztri Aerosphere 160-9-4.8 MCG/ACT Aero Generic drug: Budeson-Glycopyrrol-Formoterol 2 inhalations, Inhalation, 2 TIMES DAILY metOLazone 10 MG Tabs Commonly known as: ZAROXOLYN 10 mg, Oral, DAILY morphine 30 MG Tbcr Commonly known
Current Illness:
Preexisting Conditions: COPD (chronic obstructive pulmonary disease) (CMS-HCC: 111)
Allergies: NKDA
Diagnostic Lab Data: SARS-COV-2 NAA, Detected 08/03/21.
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 02/23/21. Patient hospitalized from 08/03/21 - 08/09/21. Below is copied from discharge summary: Hospital course: had a ground level fall. Found to have a traumatic pneumothorax. A chest tube was placed. She worked on respiratory treatments. Past medical history significant for COPD and Covid positive. Chest tube fell out 8/5. No pneumothorax remained. she worked on pulmonary exercise and worked with therapy. Discharge to home with HHPT.


VAERS ID: 1545919 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-08-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site reaction, Injection site swelling, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: bupropion 300mg daily, levonor-eth estrad 0.1-.0.02MG
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site: swollen, red welt, itchy, warm to touch -Lasted 3 days, felt better for 2 days then the same symptoms began again for 2 days


VAERS ID: 1546113 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Hyperhidrosis, Pruritus, Rash, Rash macular, Rash papular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aderall xr 20 mg, Xanax .25, multivitamin, collagen powder, vitamin C
Current Illness: None
Preexisting Conditions: Add, anxiety
Allergies: Walnuts, sensitive to topical lotions, dyes,fragrances, food sensitivities
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the vaccine Moderna and about 8-10 hours later my entire body became itchy and blotchy looking until about Saturday I could not stop itching. I took 50 of Bendaryl the first day and went to bed. I then woke up had small raised dots appear on my bilateral legs. I took more antihistamines (Claritin) and steroid shot. I never had anapylaxis and The rash went away within 72 hours. 7 days later I feel fine but have felt like my body is one minute sweating and then next freezing. Im not sure if this was related.


VAERS ID: 1546117 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No known prescriptions, supplements or OTC medications.
Current Illness: No known illnesses
Preexisting Conditions: No known chronic or health conditions
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was being monitored after receiving J&J shot for 15 minutes as recommended by the CDC. Shortly after receiving the shot, she approached the counter feeling dizzy and unwell. I immediately grabbed a chair and sat her down to prevent a head injury if the patient were to faint. Once she sat down, her eyes rolled in the back of her head, and she seemed to be unconscious. She was awake but was definitely not 100 percent with it. I gave her water for hydration and glucose tablets for possible hypoglycemic episode. She came back around after approximately 15 seconds. I let her rest, monitored her symptoms. She was in a foggy state at this point and doesn''t really remember completely. I asked if she would have liked me to contact EMS and she declined. I then suggested to have her mother pick her up to prevent another episode while driving home alone. She rested, and I monitored her. After about 15 minutes she was feeling better and I suggested to walk around. I gave her a brief cognitive evaluation to make sure there were no signs/symptoms of stroke or anything to be concerned with. Her mom arrived approximately 30 minutes later. I explained what happened and the patient was feeling much better. She left her car here, and I advised her to notify us if anything else happened.


VAERS ID: 1546541 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-22
Onset:2021-08-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Feeling abnormal, Heavy menstrual bleeding, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Depression exacerbated
Other Medications: Wellbutrin 350 and Lexapro 5 mg
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish, Bactrim, tetracycline, amoxicillin, sulfa drugs, laytex
Diagnostic Lab Data: None. It didn?t seem like there was anyone I could turn to for help, unless I was dying. Which seems to be the only measurement here.
CDC Split Type:

Write-up: I got my period on 7/20 and was vaccinated on 7/22. On August 2nd, less than two weeks after the first day of my last period I started bleeding heavily. That lasted about 4 days. However, I have not stopped bleeding completely as of today8/11/21.. I have been like clockwork with my cycle since I was 17. Unless I was pregnant, I have not missed a period or had a cycle shorter than 23 days. Once I got my period back after having a baby, it was never erratic, ever. It always went straight back. I have so many questions and think it?s completely unfair to not mention this would happen , and to not give me any explanation at to why. As far as I know I?ve completely messed up my hormones. Also, around the same time I started bleeding vaginally I developed 7 bruises on my left leg. 4 on my left foot, one on my left ankle and two on my left calf. I have no recollection of hurting myself. Also, I never bruise. I was also foggy for about 3 weeks, but that?s the least often side adverse side effects.


VAERS ID: 1546700 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Second night after the vaccination, I woke up to use the restroom. I passed out and found myself laying on the floor, not sure how long has passed. Something like this never happened before.


VAERS ID: 1547510 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Pruritus
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210820368

Write-up: REDNESS (CIRCULAR, SIZE OF A NICKEL IN RADIUS) ON THE LEFT ARM JUST BELOW THE INJECTION SITE AND IT LOOKS LIKE A MOSQUITO BITE; ITCHY REDNESS ON THE LEFT ARM; This spontaneous report received from a patient concerned a 75 year old male. The patient''s weight was 155 pounds, and height was 67 inches. 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: 043A21A, expiry: UNKNOWN) dose was not reported, administered on 31-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the patient experienced redness (circular, size of a nickel in radius) on the left arm just below the injection site and it looks like a mosquito bite. On 03-AUG-2021, the patient experienced itchy redness on the left arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from redness (circular, size of a nickel in radius) on the left arm just below the injection site and it looks like a mosquito bite, and itchy redness on the left arm. This report was non-serious.


VAERS ID: 1548936 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 09ID21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Fatigue, Muscle spasms, Oropharyngeal pain, Rhinorrhoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (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: Tylenol 500mg (as needed)
Current Illness: Asthma Seasonal Allergies
Preexisting Conditions: Asthma Seasonal Allergies
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Cough, fatigue, sore throat, wheezing, slight muscle spasms in right thigh, runny nose


VAERS ID: 1548998 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Dyspnoea, Hypoxia, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: About one week ago he began to experience progressive shortness of breath, dyspnea and cough. He tested positive for COVID-19 as an outpatient at that time. He has been checking his O2 sat at home and noted decreased O2 saturations. He called EMS and was found to be hypoxic in the field into the mid 80''s. He has improved with O2 via nasal canula and has radiographic findings consistent with COVID-19 pneumonia.


VAERS ID: 1549058 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-04
Onset:2021-08-03
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 UN / SYR

Administered by: Pharmacy       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: Patient had no symptoms, patient tested positive during an OP appointment


VAERS ID: 1549164 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-09
Onset:2021-08-03
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Contusion, Full blood count normal, Prothrombin time normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

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

Write-up: Pt developed bruising about 3 weeks after vaccination


VAERS ID: 1549211 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Dyspnoea, Fatigue, Headache, Irritability, Pain, Pain in extremity, Pulmonary pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Laminthaol Trazadone 150mg @ night Meloxicam Methazole Vitamin D3 Zinc Women''s supplement Rescue inhaler Advair inhaler Takes one shot once a week Orzimpic
Current Illness:
Preexisting Conditions: Lung Damage COPD Diabetes Osteopartis Depression
Allergies: Codeine Penicillin Rosati Seroquel
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that an hour after she received the vaccination she felt a pain in her lungs. She had a hard time breathing for about 6 hours. She received a bad headache. Her vision started to go in and out of vision. She is tired all the time. She is sleeping for 3 or 4 hours in the day time. She said her body hurts to walk. Her arms are sore and she is very irritated.


VAERS ID: 1549297 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Lip pruritus, Lip swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Lips swelled 24 hours after receiving first dose. No history of dermal fillers. Lip swelling was very itchy and lasted 5 hours. Also difficulty breathing began around that time and progressively got worse until 8/11/2021, when I decided to go to the ER. They could not give me an explanation of why I was having difficulty breathing. I am still having chest discomfort as I am writing this.


VAERS ID: 1549395 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-20
Onset:2021-08-03
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Acute respiratory failure, COVID-19, General physical health deterioration, Intensive care, Mechanical ventilation, Oxygen saturation decreased, Pneumonia viral, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine 10 mg PO qDay aspirin 81 mg PO qDay , Synthroid 0.025 mg PO qAM losartan 50 mg PO qDay mycophenolate mofetil 250 mg PO BID Phospha 250 Neutral 250 mg PO BID predniSONE 5 mg PO qDay simvastatin 10 mg PO at be
Current Illness:
Preexisting Conditions: HTN, s/p renal transplant, ESRD on HD, prostate cancer
Allergies: penicillins, ciprofloxacin, oxycodone
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/3/21: Patient arrived at the ER due to worsening O2 saturations (low 70s) due to COVID diagnosis. Patient tested positive for COVID on 7/31/21. Patient transferred to ER on 8/3. Upon admission to PCU, patient had rapid response, and is now in ICU on mech vent. Diagnosed with acute resp failure 2/2 ARDS/COVID, viral pneumonia Please note: Patient received First dose of Pfizer COVID-19 vaccine on 3/30/2021, followed by the second dose on 4/20/2021 (confirmed through electronic system) 8/12/2021: patient still admitted at the time of this report submission


VAERS ID: 1549451 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Face injury, Fall, Fatigue, Haemorrhage, Hunger, Thirst
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: "After patient consented and received J&J vaccine he was asked to sit and wait for 15 minutes in our observation area under a tent. Patient asked for a water and it was provided. After about 12 minutes patient fell forward out of his chair and landed on the cement. Patient used his hands to break the fall but still managed to get a small cut on his chin. He did not have any injuries on his hands. He lost very little blood, maybe about 3 drops. Patient''s cut was cleaned and dressed. Patient denied any chest pain, SOB, headache, or faintness. Patient kept repeating he was fine just hungry, thirsty, a little dizzy, and tired. Patient states he had only eaten cereal and toast earlier and did not sleep well last night. "After patient consented and received J&J vaccine he was asked to sit and wait for 15 minutes in our observation area under a tent. Patient asked for a water and it was provided. After about 12 minutes patient fell forward out of his chair and landed on the cement. Patient used his hands to break the fall but still managed to get a small cut on his chin. He did not have any injuries on his hands. He lost very little blood, maybe about 3 drops. Patient''s cut was cleaned and dressed. Patient denied any chest pain, SOB, headache, or faintness. Patient kept repeating he was fine just hungry, thirsty, a little dizzy, and tired. Patient states he had only eaten cereal and toast earlier and did not sleep well last night due to a lot of noise in his house. Pt was given food and water provided by staff. He denied any dizziness when he stood up with help from worker and I and he sat back on the chair. I advised patient to wait another 15 min to be observed, he acknowledged. There was no need to activate 911 at this time. After completing over 40 minutes of observation and finishing his food, patient left in stable condition. ER precautions were explained."


VAERS ID: 1549544 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Intermenstrual bleeding, Loss of personal independence in daily activities, Pruritus, Rash erythematous, Rash papular, Skin warm, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza shot, 24 hours flu like symptoms with vomiting. She was 28.
Other Medications: Went to store and purchased Benadryl after calling doctors office. Itching all over, raised red spots. Went away in about 24 hours.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None known.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Itching all over with raised red spots that were warm to the touch. Vomiting followed before bedtime and next day. Was out of work 3 days.


VAERS ID: 1549568 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dysphonia, Oral pruritus, Rash erythematous, Respiration abnormal, Tongue discomfort
SMQs:, Anaphylactic reaction (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: strange feeling in tongue, tight in chest, scratchy voice, hoarse voice, itching around moth, abnormal breathing, coughing, injection site produced sunburn mark


VAERS ID: 1549593 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Anticoagulant therapy, Body temperature increased, Chest X-ray, Chest discomfort, Chest pain, Chills, Dyspnoea, Electrocardiogram, Fatigue, Hot flush, Peripheral coldness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Blood Pressure Medication
Current Illness: no known
Preexisting Conditions: Abnormal Heart Rhythm
Allergies: NKDA
Diagnostic Lab Data: temp 99.6-100.4 was given Tylenol, baby aspirin, IV fluids, CXR, EKG
CDC Split Type:

Write-up: Woke up the next morning after vaccination felt hands feet very cold, and chills, drove to hospital, temp 99.6-100.4 was given Tylenol, baby aspirin, IV fluids, CXR, EKG, SOB chest pain, chest tightness. Was under observation for 24-28 hours, continued with Tylenol until discharge, has been feeling well since, some hot flash feeling and fatigue not unusual but not numbness or tingling has been noted since


VAERS ID: 1549656 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-08
Onset:2021-08-03
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Myalgia, Nausea, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/20/21 pfizer,Lot#EK5730 2nd dose 01/08/21 Pfizer,lot#EL3248 Diagnosed covid positive:08/03/21 Symptom onset:08/03/21 Exposure:Travel Symptoms:Fever, cough, fatigue,muscle aches,nausea/vomiting


VAERS ID: 1549661 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-03
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Diarrhoea, Hyperhidrosis, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/06/21 pfizer,Lot#EL3246 2nd dose 01/27/21 Pfizer,lot#EL9262 Diagnosed covid positive:08/03/21 Symptom onset:08/03/21 Exposure:Travel Symptoms:Loss of smell/taste,congestion,sore throat,diarrhea,chills, sweating.


VAERS ID: 1549786 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-28
Onset:2021-08-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Headache, Loss of consciousness, Muscular weakness, Pruritus
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: singulair effexor atarax
Current Illness: none
Preexisting Conditions: asthma
Allergies: molds, pollens, dust mites
Diagnostic Lab Data: Bloodwork and CT
CDC Split Type:

Write-up: 5 days later she started having weakness in her legs. Then passed out, complained of a headache that was sharp on the left side of her head that lasted a few minutes, then started ticing all over her body and still hasn''t stopped.


VAERS ID: 1549806 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-28
Onset:2021-08-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Chills, Decreased appetite, Disturbance in attention, Electrocardiogram, Feeling abnormal, Impaired driving ability, Mastication disorder, Muscle tightness, Muscle twitching, Pain of skin, Tension headache, X-ray
SMQs:, Dementia (broad), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (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: Biotin 10,000 mcg daily, Finasteride 1.25mg daily.
Current Illness: Diabetes.
Preexisting Conditions: Diabetes.
Allergies: None.
Diagnostic Lab Data: Blood work, xrays, EKG were non concerning.
CDC Split Type:

Write-up: No immediate reaction to injection. 8/3 at approx 1AM developed extreme "Brain fog" symptom. Loss of clarity, ability to focus, overall sluggish mental feeling. Reaction time seems slightly delayed, somewhat difficulty driving, feeling of tightness/fullness in head/jaw area. Feels like my cognition became impaired in some way. *This is the most severe/impacting of the symptoms.* Other symptoms: Infrequent muscle twitching 8/4-onward, usually only at night while trying to sleep. 8/4- present - complete loss of appetite. No nausea, just no desire to eat, difficulty chewing. Liquids seem fine. Minor Intermittent chills at night 8/4. 8/4 onward sleep patterns disturbed, wake up every 2-3 hrs. Minor chest pains 8/8 - 8/10, both sides, mostly subsided now. EKG, xrays, blood work showed no related issues. Slight sensation change in tip of right thumb 8/5, and right foot noticed 8/10. Not numb, not painful, just feels different to the touch, like some form of neuropathy.


VAERS ID: 1550180 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Crying, Erythema, Induration, Nodule, Pain, Peripheral swelling, Pruritus, Rash, Swelling, Urticaria
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (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: Onion
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling and blistering began occuring at the distal L forearm/wrist on the ventral surface, approx 3 cm, and 2 more blistering welts, approx 1-2 cm, in the anticubital surface of the R arm within 4 hours of receiving the vaccination. Welts were itchy, red, and throbbing. Welts on the R anticubital surface expanded dramatically by the following morning, approx 3 inches from medial bicep to the proximal forearm. Used drying soap due to the rashs resemblance to poison ivy, though I have never had a previous reaction to nor have I been recently exposed. Welts have continued to grow in numerous other areas of both arms, several as hard nodules with dark red color and micro blisters around the perimeter. Severe itching, swelling, and weeping. Smaller blisters have begun to appear along the torso and pelvic areas.


VAERS ID: 1553460 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Loss of consciousness, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Shakiness-Mild, Additional Details: About 15 minutes after receiving the Moderna shot, patient walked up to a pharmacyand fell and blacked out for a few seconds. With permission, patient was then laid flat on the ground and elevated his legs/feet on a chair. We called 911 and epinephrine was acquired. Patient was provided water. Paramedics came and asked the patient questions. Patient was okay so they did not take him in. Patient was asked to stay another 15 minutes and afterwards, patient said he felt good and left.


VAERS ID: 1553706 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-08-03
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: oseltamivir
Current Illness:
Preexisting Conditions: COPD, ..1. Chronic obstructive pulmonary disease. 2. Hypertension. 3. Hypercholesterolemia. 4. Gastroesophageal reflux disease. 5. Unstable gait.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. is an 84-year-old female who presents to hospital with an increasing shortness of breath. The patient has chronic obstructive pulmonary disease, for which she is on DuoNebs, Stiolto. She reported increasing shortness of breath over the past several days. She presented to Emergency Room. She was diagnosed with coronavirus pneumonia and required increase in oxygen. The patient has had no chest discomfort, palpitations, syncope, or abdominal pain. 7/31/2021 tested positive


VAERS ID: 1553737 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-03-10
Onset:2021-08-03
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: ICU hospitalization for Covid 19 severe infection.


VAERS ID: 1553741 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Palpitations, Rash
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Rash on arms and chest.
Other Medications: None
Current Illness: None
Preexisting Conditions: Seasonal Asthma
Allergies: Penicilin, Cefouroxime, Amooxicillin, Ampicillin, Sulfamethoxazole and Trimethoprim
Diagnostic Lab Data: Took benadryl for rash which helped. Heart palpitations got less and less as well as chest pain as time went on. Did not go to doctor or hospital.
CDC Split Type:

Write-up: Starting on 08/03/2021 (day three) rash down both arms and on chest. Heart palpitations with some chest pain lasting about three days.


VAERS ID: 1553991 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus
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:
Other Medications: multivit, calcium
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Random skin itching, no whelps or visible signs of rash. Itching in one spot which is migratory.


VAERS ID: 1554011 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Headache, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness:
Preexisting Conditions: Seasonal allergies, reynaud syndrome
Allergies: Lidocaine, bananas, kiwis, grass, pollen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, swelling-recovered post 5 days. sustained constant headache since injection


VAERS ID: 1554278 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-08-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK - / -

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

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

Write-up: COVID-19 Pneumonia due to coronavirus disease 2019


VAERS ID: 1554321 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 RA / IM

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

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

Write-up: Moderna COVID-19 Vaccine EUA dose given 57 days after BUD for refrigeration


VAERS ID: 1554336 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

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

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

Write-up: Moderna COVID-19 Vaccine EUA dose given 67 days after BUD for refrigeration


VAERS ID: 1554344 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 RA / IM

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

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

Write-up: Moderna COVID-19 Vaccine EUA dose given 57 days after for refrigeration


VAERS ID: 1554412 (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: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / IM

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

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

Write-up: Moderna COVID-19 Vaccine EUA dose given 65 days after BUD for refrigeration


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