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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 286 out of 7,116

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VAERS ID: 1554417 (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 / 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


VAERS ID: 1554420 (history)  
Form: Version 2.0  
Age: 78.0  
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 / 1 LA / IM

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

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

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


VAERS ID: 1554427 (history)  
Form: Version 2.0  
Age: 63.0  
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 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 65 days after BUD for refrigeration


VAERS ID: 1554439 (history)  
Form: Version 2.0  
Age: 61.0  
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 / 1 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 65 days after BUD for refrigeration


VAERS ID: 1554445 (history)  
Form: Version 2.0  
Age: 35.0  
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 / 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


VAERS ID: 1554460 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-08-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Respiratory tract congestion
SMQs:

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

Write-up: mild congestion and fatigue


VAERS ID: 1554535 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-20
Onset:2021-08-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oligomenorrhoea, Pregnancy test negative
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Three OTC pregnancy tests reported negative 08/03/21, 08/05/21 and 08/07/21
CDC Split Type:

Write-up: Missed ovulation cycle within 28 days of initial dose on July 20th, 2021 - should have started period on 1st of 2nd of August, 2021


VAERS ID: 1555010 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Injection site erythema, Insomnia, Pain in extremity
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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: OPIOIDS
Current Illness: Chronic pain; Fibromyalgia
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension; Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210815644

Write-up: CANT SLEEP; WOKE UP HURTING RIGHT ARM; WEAK; SPOTTING AND REDNESS AROUND WHERE HE RECEIVED VACCINE; This spontaneous report received from a patient concerned a 57 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: chronic pain, fibromyalgia, and hypertension. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) .5 ml, administered on 03-AUG-2021 for prophylactic vaccination. Concomitant medications included for chronic pain. The batch number was not reported and has been requested. On 03-AUG-2021, the patient experienced cant sleep. On 03-AUG-2021, the patient experienced woke up hurting right arm. On 03-AUG-2021, the patient experienced weak. On 03-AUG-2021, the patient experienced spotting and redness around where he received vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from woke up hurting right arm, and weak, and the outcome of cant sleep and spotting and redness around where he received vaccine was not reported. This report was non-serious. This report was associated with product quality complaint: 90000188853. The suspected product quality complaint has been confirmed to be voided(did not meet a product quality complaint criteria as reported complaints were adverse events) based on the Agency evaluation/investigation performed.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1555774 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Exercise tolerance decreased, Hyperhidrosis, Hypoaesthesia, Illness, Malaise, Pain in extremity, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient was usually very healthy and did not take any medication.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210819997

Write-up: SWEATING; SICKNESS; NOT ABLE TO DO EXERCISE FOR WEEK; ANXIETY; FEET AND TOES WERE NUMB; NUMBNESS IN CALVES; SORE ARM; NOT FEELING WELL; FEVER; This spontaneous report received from a parent concerned a 21 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: non-alcohol user, and non-smoker, and other pre-existing medical conditions included: The patient was usually very healthy and did not take any medication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 03-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-AUG-2021, the patient experienced sweating. On 03-AUG-2021, the patient experienced sickness. On 03-AUG-2021, the patient experienced not able to do exercise for week. On 03-AUG-2021, the patient experienced anxiety. On 03-AUG-2021, the patient experienced feet and toes were numb. On 03-AUG-2021, the patient experienced numbness in calves. On 03-AUG-2021, the patient experienced sore arm. On 03-AUG-2021, the patient experienced not feeling well. On 03-AUG-2021, the patient experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sweating, and numbness in calves on 05-AUG-2021, had not recovered from sore arm, not able to do exercise for week, and feet and toes were numb, and the outcome of fever, not feeling well, sickness and anxiety was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1558034 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pruritus
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol, Synthroid, Omeprazole, Rosuvastation, Xanax (as needed), multi vitamin, Probiotics, Memory Support, Calcium, D-3
Current Illness: N/A
Preexisting Conditions: Shortness of breath
Allergies: IVP Dye, Ambien, Codeine, Bactrim, Zinc, Bar Soap, Body Lotions, Fabric Softeners, Scented Detergent, Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lightheaded for about 7 hours. extremely itchy and still itching 10 days later. Taking Benadryl for some relief at bedtime.


VAERS ID: 1558115 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Injection site erythema, Injection site rash, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitafusion Vitamin D gummy Vitafusion womens multi vitamin gummy Natures bounty milk thistle Natures bounty cinnamon
Current Illness: None
Preexisting Conditions: Osteoarthritis, DDD
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red, hard rash around injection site, muscular pain left arm, diarrhea, fatigue


VAERS ID: 1562812 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Swelling at Injection Site-Mild


VAERS ID: 1570791 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Injection site pain, Muscular weakness, Musculoskeletal stiffness, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Extreme fatigue began at 8pm on day of shot 8/03. Shortly followed by chills, headache, and a fever of 100?. By 2 am on 08/04 nausea and vomiting started. Nausea ceased by 8 am. Entire day of 08/04 fever remained between 99? and 100?. Arm pain at the site of the injection was very painful and stiff for 72 hours. After 48 hours most other symptoms began to decrease. General weakness continued for 4 days after the initial shot when strength began to return, but weakness in the left leg has continued to date.


VAERS ID: 1573821 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 622M26A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Injection site mass, Injection site pain, Injection site pruritus, Injection site swelling, Injection site urticaria, Injection site warmth, Neck pain, Pain
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis, Venlafaxin
Current Illness: None
Preexisting Conditions: Pulmonary Fibrosis related to PE
Allergies: Moderna Orthotrycycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site shows hives, bump, itching, swelling, and heat for 10 days plus after injection. Muscle pain radiating from injection site up the neck and into the the back, as well as left side pain. Symptoms have NOT been resolved as of 8/16/2021.


VAERS ID: 1573947 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-22
Onset:2021-08-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Synthetic, wellbutrin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heavier than usual period, spotting and cramps in-between periods.


VAERS ID: 1574017 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-27
Onset:2021-08-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vit, vit c, vit e, vit d, zinc, melatonin, aspirin, mortran, lisinopril, indur, lipitor, busbar, co-reg, Norvasc, flexarell, oxycodone, glimepiride, metformin
Current Illness: on going back problems
Preexisting Conditions: back problems 6 back surgeries
Allergies: green dye, steroid,
Diagnostic Lab Data:
CDC Split Type:

Write-up: got Shingles after taking the vaccine


VAERS ID: 1574159 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-02
Onset:2021-08-03
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Intensive care
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, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized in the ICU


VAERS ID: 1574179 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hemiplegia, Hypoaesthesia oral, Pain in extremity
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Soreness in left arm, chills, tongue and lips numb and z right side of face paralyzed.


VAERS ID: 1574228 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Bone pain, Electrocardiogram, Headache, Hot flush, Hyperhidrosis, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: ASA, cats, tuna
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Per the patient, she received the vaccine with her PCP. She claimed that she developed the following on the day of vaccination - headaches, nausea, vomiting, hot flush, sweating ,and bones are achy. Patient / employee claimed that the above symptoms continued to manifest and became worse on August 13, 2021.


VAERS ID: 1574334 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-06
Onset:2021-08-03
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, COVID-19, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
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 01/09/21Lot# 2nd dose02/06/21 ,lot# Diagnosed covid positive:08/07/21 Symptom onset:08/03/21 Exposure: Symptoms:Runny nose, loss of smell


VAERS ID: 1574342 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-19
Onset:2021-08-03
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Fatigue, Myalgia, Pyrexia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 01/19/21Lot#EL0142 2nd dose 12/29/20lot#EL3247 Diagnosed covid positive:08/06/21 Symptom onset:08/03/21 Exposure:work Symptoms:fever, cough, fatigue, muscle aches,chills, runny nose.


VAERS ID: 1574361 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-03
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, COVID-19, Cough, Rhinorrhoea, SARS-CoV-2 test positive, Throat irritation
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/07/21Lot#EL3248 2nd dose 01/27/21,lot#EL9262 Diagnosed covid positive:08/05/21 Symptom onset:08/02/21 Exposure: Symptoms:Cough, loss of smell, scratchy throat,runny nose, loss of smell.


VAERS ID: 1574362 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-13
Onset:2021-08-03
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Headache, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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 03/23/21Lot#ER8727 2nd dose 04/13/21,lot#EW0150 Diagnosed covid positive:08/05/21 Symptom onset:08/03/21 Exposure:community Symptoms:fatigue,runny nose,sore throat,headache.


VAERS ID: 1574363 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-03
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Fatigue, Headache, Myalgia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/06/21 Lot#EL3248 2nd dose 01/27/21,lot#EL9262 Diagnosed covid positive:08/05/21 Symptom onset:08/03/21 Exposure:community Symptoms:cough, fatigue,muscle aches, chills,headache


VAERS ID: 1574431 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-27
Onset:2021-08-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Baclofen 10mg, meloxicam 7.5mg
Current Illness: Back pain
Preexisting Conditions: none noted
Allergies: NKDA
Diagnostic Lab Data: Positive Covid 19 test 8/3/21
CDC Split Type:

Write-up: Hospitalization due to COVID


VAERS ID: 1574509 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-03
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Myalgia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 dose01/06/21 Lot#EL3248 2nd dose 01/27/21,lot#EL9262 Diagnosed covid positive:08/07/21 Symptom onset:08/03/21 Exposure: Symptoms:muscle aches, cough, runny nose, headache.


VAERS ID: 1574657 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-02-06
Onset:2021-08-03
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Positive COVID PCR on 8/3/2021


VAERS ID: 1577529 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Chest X-ray, Cough, Mononucleosis heterophile test, Nasal discomfort, Oropharyngeal pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Anxiety; Attention deficit hyperactivity disorder; Cigarette smoker (Half a packet a day); Depression
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210805; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: Negative; Test Date: 20210805; Test Name: SARS-CoV-2 RT-PCR test; Result Unstructured Data: Negative; Test Date: 20210814; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: Negative; Test Date: 20210814; Test Name: Chest X-ray; Result Unstructured Data: Normal; Comments: 2 chest X-Ray were taken and both were normal.; Test Name: Mononucleosis heterophile test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210830301

Write-up: SHARP PAIN IN BACK; COUGH; SORE THROAT (THAT''S GETTING WORSE); NASAL IRRITATION; This spontaneous report received from a patient concerned a 33 year old female. The patient''s weight was 200 pounds, and height was 64 inches. The patient''s concurrent conditions included: anxiety, cigarette smoker, non-alcohol user, depression, and attention deficit hyperactivity disorder (adhd), and other pre-existing medical conditions included: The patient had no known allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 20-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the patient experienced sore throat (that''s getting worse). On 03-AUG-2021, the patient experienced nasal irritation. On 05-AUG-2021, Laboratory data included: SARS-CoV-2 RT-PCR test (NR: not provided) Negative, and SARS-CoV-2 rapid diagnostic test (NR: not provided) Negative. On 06-AUG-2021, the patient experienced cough. On 10-AUG-2021, the patient experienced sharp pain in back. On 14-AUG-2021, Laboratory data included: Chest X-ray (NR: not provided) Normal, and SARS-CoV-2 rapid diagnostic test (NR: not provided) Negative. Laboratory data (dates unspecified) included: Mononucleosis heterophile test (NR: not provided) Negative. Treatment medications (dates unspecified) included: azithromycin. The action taken with covid-19 vaccine was not applicable. The patient was recovering from nasal irritation, and cough, and had not recovered from sore throat (that''s getting worse), and sharp pain in back. This report was non-serious.


VAERS ID: 1578153 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-24
Onset:2021-08-03
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Lost of taste and smell


VAERS ID: 1578207 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-08-03
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
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? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalized 8/3-8/9 J&J on 3/10/21. Positive on 7/25


VAERS ID: 1578209 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / IM

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

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

Write-up: 1ST DOSE MODERNA VACCINE GIVEN TO 13 YEAR OLD MALE ON 8/3/2021. NO NEGATIVE OUTCOME TO PATIENT AS PER GRANDMOTHER. NOTICED THE ERROR ON 8/17/2021 WHEN SUBMITTING VACCINE FORM. CALL PLACED TO GRANDMOTHER NOTIFIED AND SHE REPORTS THE CHILD IS FINE AND NO ISSUES AFTER THE VACCCINE. SHE REPORTED THAT HER GRANDSON''S FRIENDS ALSO RECEIVED THIS VACCINE AT ANOTHER CLINIC AND THERE WAS HER PREFERRED VACCINE.


VAERS ID: 1578218 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / IM

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

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

Write-up: 1ST DOSE MODERNA VACCINE GIVEN TO 12 YEAR OLD FEMALE ON 8/3/2021. NO NEGATIVE OUTCOME TO PATIENT AS PER GRANDMOTHER. NOTICED THE ERROR ON 8/17/2021 WHEN SUBMITTING VACCINE FORM. CALL PLACED TO GRANDMOTHER NOTIFIED AND SHE REPORTS THE CHILD IS FINE AND NO ISSUES AFTER THE VACCCINE. SHE REPORTED THAT HER GRANDAUGHTER''S FRIENDS ALSO RECEIVED THIS VACCINE AT ANOTHER CLINIC AND THIS WAS HER PREFERRED VACCINE.


VAERS ID: 1578529 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-25
Onset:2021-08-03
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Respiratory tract congestion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler anastrozole (ARIMIDEX) 1 mg chemo tablet biotin 10 mg tablet budesonide-formoteroL (SYMBICORT) 160-4.5 mcg/actuation inhaler calcium carbonate-vitamin D3 600 mg(1,500mg) -200 unit per tabl
Current Illness:
Preexisting Conditions: Problem List 7 items Respiratory Chronic obstructive pulmonary disease (CMS/HCC) Digestive Diverticulosis Other Anxiety Breast microcalcification, mammographic Breast cancer (CMS/HCC) Encounter for screening mammogram for malignant neoplasm of breast History of breast cancer
Allergies: Allergies CiprofloxacinOther (document details in comments) ClarithromycinHeadaches DoxycyclineOther (document details in comments) GarlicOther (document details in comments) LevofloxacinOther (document details in comments) MoxifloxacinOther (document details in comments)
Diagnostic Lab Data: 08/08/21 0008 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/07/21 1615 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/08/21 0008 COVID-19 PCR Collected: 08/07/21 1615 | Final result | Specimen: Swab from Nares
CDC Split Type:

Write-up: covid exposure last tuesday. cough, fatigue, congestion, sob.


VAERS ID: 1578604 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-24
Onset:2021-08-03
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

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? 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 + PCR TEST
CDC Split Type:

Write-up: PATIENT CONTRACTED COVID $g2 WEEKS AFTER LAST DOSE OF VACCINATION SERIES


VAERS ID: 1578605 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-08
Onset:2021-08-03
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Hypoxia, Intensive care, Respiratory symptom, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
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: DM 2, HTN, HFpEF, CAD, Aflutter
Allergies: none
Diagnostic Lab Data: tested COVID positive 8/3/21
CDC Split Type:

Write-up: contracted COVID, developed respiratory symptoms including severe hypoxia, required brief MICU stay


VAERS ID: 1578970 (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: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / N/A RA / IM

Administered by: Unknown       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: received 3rd dose; patient confirmed verbally it was his first dose, but upon review of records, patient already had 2 doses


VAERS ID: 1578985 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: Numbness in left arm, left side of neck and left side of face, on 8/4/2021. Resolved without treatment.


VAERS ID: 1579211 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

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

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

Write-up: Patient was underage, she reported she was 12 - but was in fact 11 years old.


VAERS ID: 1579749 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-10
Onset:2021-08-03
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A12A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Muscle spasms, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: PT said these symptoms happened 2 weeks ago. Symptoms include: severe leg cramps, left hip pain/cramp, shoulder pain on the same side of injection. She also felt very fatigue and sleepy since 8/15.


VAERS ID: 1579761 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anti-transglutaminase antibody, Bacterial test, Blood thyroid stimulating hormone, Diarrhoea, Erythema, Faecal calprotectin, Fatigue, Feeling hot, Full blood count, Hyperhidrosis, Lipase, Malaise, Metabolic function test, Occult blood, Parasite stool test, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: duo neb, finacea, coq10, vitamin b12, flexeril, allegra, allegra-d, fluocinolone ointment, flovent, vlonase, lidoderm, singulair, naproxen, elidel, maxalt, rosuvastatin, senokot-s, albuterol, vitamin d
Current Illness: none known
Preexisting Conditions: asthma, hyperlipidemia, fatty liver, migraines, chronic back pain, rosacea, eczema, allergic rhinitis, obesity
Allergies: latex gadolinum contrast penicillin sulfa iodine bee sting
Diagnostic Lab Data: 8/16/21 testing for cbc, cmp, lipase, tsh, ttg with iga, stool calprotectin, o&p, hemoccult, bacteria panel ordered and pending
CDC Split Type:

Write-up: Patient started having fatigue 8/3/21. Started feeling warm 8/7/21-8/8/21. Diarrhea started 8/10/21. Feeling feverish with fever to 101.9F 8/11/21-8/15/21. Sweating, feeling generally ill. Patchy skin redness.


VAERS ID: 1582106 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Impaired work ability, Muscle spasms, Night sweats, Pyrexia, SARS-CoV-2 test negative, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: Negative PCR test on August 11th to confirm I hadn?t actually caught the virus
CDC Split Type:

Write-up: Fever that was between 102-104 for 12 days straight unbroken (even after medication - Tylenol). Severe night sweats to the point I was being woken up by cramps in my calf (drank 1-2 gallons of water a day because of this). Severe headaches - almost went to the hospital. Was unable to work for almost two weeks.


VAERS ID: 1582410 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-08
Onset:2021-08-03
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, SARS-CoV-2 test positive, Speech disorder, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: This is a 73-year-old male resident of healthcare who was transferred from his dialysis session with a report that he was different from baseline. He arrived alert but was not answering questions or following commands. He was noted to have a cough. His past medical history is significant for vascular dementia, anemia, BPH, bleeding hemorrhoids, ESRD on dialysis (Tuesday, Thursday and Saturday sessions), GERD, GI bleed, XRT for prostate cancer, hypertension. He was reportedly in his usual state of health and alert and responsive. Staff at dialysis noted he was not responding or speaking is normal. He was able to complete his dialysis session. Then sent to ER for evaluation. Started zosyn for possible pneumonia but This was later discontinued as he had no clinical signs of pneumonia and his imaging results were reviewed. COVID-19 was positive. He remained afebrile throughout his stay and had no clinical signs of pneumonia and chest was clear. He was retested for Covid on 8/8 which resulted negative. Discharged on 8/11/21.


VAERS ID: 1582458 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7488 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Electrocardiogram, Heavy menstrual bleeding, Loss of consciousness, Menstrual disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/A
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: I passed out on 8/14/2021, blood work was taken to test Iron due to loss and continued loss of blood. I had an EKG, and chest X-ray.
CDC Split Type:

Write-up: Started bleeding on August 3rd somedays heavy bleeding occurred this was not the normal period, and was not close to time for cycle . I am still experiencing bleeding.


VAERS ID: 1582563 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Feeling abnormal, Headache, Pain in extremity
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonazapan, Lexpro, Vitamin D, B12, Calcium, Nexium. I also had an MMR vaccine on 7-28-2021 for work because it was required and I did not have my childhood vaccine records so they made me repeat it after doing the antibodies blood work.
Current Illness: None
Preexisting Conditions: Depression
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Every since I had the 2nd vaccine I have had daily headaches, I am so tired and weak. My arms and legs hurt every day, really bad. I have no strength. I have to muster up the strength to just walk around. I just feel terrible. This is not normal for me. I never experienced any of these symptoms before this shot. I was a healthy person pre vaccine.


VAERS ID: 1582600 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-08-03
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccinated then came down with COVID.


VAERS ID: 1582682 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH D11SS9E / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BUPROPION HCL 100MG ESCITALOPRAM 10MG HYDROXYZINE HCL 25MG CETIRIZINE 10MG MONTELUKAST SOD 10MG
Current Illness:
Preexisting Conditions: ANEMIA
Allergies: SEASONAL ALLERGIES, POLLEN AND DUST AND DAIRY
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: FEVER , SORE BODY , SWEATING AND INSOMNIA.


VAERS ID: 1582700 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dyspepsia, Headache, Inflammation, Nausea, Pain, Palpitations
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad)

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:
Other Medications:
Current Illness:
Preexisting Conditions: Polycystic ovaries
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Around 2am, I began getting very intense heart palpitations, headaches, body aches and nausea. This continued for 48 hours. It has been 15 days since my shot -- I was perfectly healthy before -- and now I am completely a mess. I have whole body inflammation and joint pain, frequent headaches, and my digestion is not functioning properly.


VAERS ID: 1582786 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-02
Onset:2021-08-03
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fall, Injury, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (narrow), Hostility/aggression (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? Yes
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 mg tablet bisacodyL (DULCOLAX) 10 mg suppository carBAMazepine (CARBATROL) 200 mg 12 hr capsule cycloSPORINE (RESTASIS) 0.05 % ophthalmic emulsion doxazosin (CARDURA) 4 mg tablet fenofibrate (TRICOR) 145 mg tablet finasteride (PR
Current Illness:
Preexisting Conditions: Nervous Atherosclerosis of native artery of right lower extremity with intermittent claudication (CMS/HCC) Carpal tunnel syndrome Cervical radiculopathy Trigeminal neuralgia Horner''s syndrome Disorder of peripheral nervous system Pseudoclaudication Lower abdominal pain Dementia (CMS/HCC) SIADH (syndrome of inappropriate ADH production) (CMS/HCC) Respiratory SOB (shortness of breath) Cough Circulatory TIA (transient ischemic attack) Hypertension Peripheral vascular disease (CMS/HCC) Atherosclerosis of artery Digestive Acid reflux Adenomatous polyp of colon Hepatitis B virus infection Diverticulosis Irritable bowel syndrome Other constipation Genitourinary Enlarged prostate without lower urinary tract symptoms (luts) Acute urinary retention Musculoskeletal Acquired spondylolisthesis Arthritis Arthropathy of right shoulder Osteoarthritis of cervical spine Hiatal hernia Generalized osteoarthritis of multiple sites Disc disorder of cervical region Degeneration of intervertebral disc of lumbar region Degeneration of intervertebral disc of cervical region Trochanteric bursitis Spondylosis of cervical region without myelopathy or radiculopathy Somatic dysfunction of spine, sacral Skin cancer Squamous cell carcinoma of skin of face Rosacea Lumbar spondylosis Olecranon bursitis of right elbow Osteoarthrosis, localized, primary, knee Primary localized osteoarthrosis of the knee Rash and nonspecific skin eruption Basal cell carcinoma of skin Tear of left deltoid muscle, subsequent encounter C1 cervical fracture (CMS/HCC) C2 cervical fracture (CMS/HCC) Forehead laceration, initial encounter Endocrine/Metabolic Hypercholesterolemia Pre-diabetes Chronic hyponatremia Acute hypokalemia Hypomagnesemia Hematologic Anemia of chronic disease Other Abnormal weight loss Ambulatory dysfunction Vertigo Lumbar canal stenosis History of squamous cell carcinoma of skin Squamous cell carcinoma Personal history of colonic polyps FH: colon cancer Bloating Fall COVID-19 virus detected
Allergies: AmoxicillinAnaphylaxis OxacillinHives / Urticaria ClindamycinDiarrhea PenicillinsRash
Diagnostic Lab Data: 08/03/21 1240 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/03/21 1106 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/03/21 1240 COVID-19 PCR - Communal Living / SNF Placement (Asymptomatic) Collected: 08/03/21 1106 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 7/29/2021 - 8/13/2021 (15 days) Hospital DUE TO Presenting Problem/History of Present Illness/Reason for Admission Trauma, Fall from standing, initial encounter He was to be discharged on 8/3 however, Covid test prior to discharge resulted positive. He kept in hospital for 10 days during isolation. He remained asymptomatic and his hospital course was otherwise uneventful. On 8/13, he was discharged back to transitions nursing facility.


VAERS ID: 1582807 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-03
Onset:2021-08-03
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 RNA increased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), 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: amLODIPine (Norvasc) 5 mg tablet aspirin 81 mg tablet BD ULTRA-FINE SHORT PEN NEEDLE 31 gauge x 5/16" needle blood-glucose meter (ONETOUCH VERIO REFLECT METER) misc butalbitaL-acetaminophen 50-300 mg capsule butorphanol tartrate (BUTORPHANO
Current Illness:
Preexisting Conditions: Nervous Hyperglycemic hyperosmolar nonketotic coma Migraine headache Diabetic polyneuropathy associated with type 2 diabetes mellitus Narcotic dependency, continuous Chest pain Respiratory Acute pulmonary edema Shortness of breath Circulatory Hypertension Hypertensive emergency Digestive Dilated bile duct Genitourinary Infected cyst of Bartholin''s gland duct AKI (acute kidney injury) Musculoskeletal Cat bite, initial encounter Cellulitis of left hand Arm wound, left, initial encounter Wound infection Tenosynovitis of forearm Endocrine/Metabolic Cushing''s syndrome Diabetes mellitus Hypokalemia Mixed hyperlipidemia Multinodular goiter Uncontrolled type 2 diabetes mellitus with hyperglycemia Hypoglycemia Nontoxic uninodular goiter Bilateral adrenal adenomas Nontoxic nodular goiter Infectious/Inflammatory MRSA (methicillin resistant Staphylococcus aureus) Other Difficulty speaking Tobacco use disorder
Allergies: AspartameNausea and Vomiting, Headaches OtherNausea Only, Headaches
Diagnostic Lab Data: 08/05/21 0310 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/04/21 1939 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/05/21 0310 COVID-19 PCR Collected: 08/04/21 1939 | Final result | Specimen: Swab from Nares
CDC Split Type:

Write-up: Patient is a 60 y.o. female Chief Complaint Patient presents with ? Cough husband positive ? Fever ? Sore Throat ? Generalized Body Aches


VAERS ID: 1583075 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Coordination abnormal, Dyskinesia, Dysphemia, Dyspnoea, Electroencephalogram, Fatigue, Feeling abnormal, Gait disturbance, Headache, Laboratory test, Magnetic resonance imaging, Muscle spasms, Muscle twitching, Oral pruritus, Pain in extremity, Speech disorder, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Hashimoto''s
Preexisting Conditions: Hashimoto''s
Allergies: None
Diagnostic Lab Data: MRI, CT scans, EEG, chest xray, lab work
CDC Split Type:

Write-up: 30 minutes after receiving vaccine developed shortness of breath, throat tightness, itchy throat/mouth, body spasm and extreme pain to upper and lower extremities, difficulty walking. The next day felt fatigue and hand twitching. Then, developed stutter, difficulty speaking, involuntary head movement and hand jerking, brain fog, headaches, and loss of coordination.


VAERS ID: 1583083 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-08-03
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Pharyngitis, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cholecalciferol, vitamin D3, 25 mcg (1,000 unit) capsule
Current Illness:
Preexisting Conditions: Nervous Left hip pain Thumb numbness Lip numbness Respiratory Pulmonary nodules Sarcoidosis of lungCirculatory Mediastinal adenopathy Internal carotid artery stenosis Musculoskeletal Achilles tendinitis Primary osteoarthritis of left hip Spondylosis of lumbar region without myelopathy or radiculopathy Acquired spondylolisthesis of lumbosacral region Endocrine/Metabolic Other hyperlipidemia Other Transient global amnesia
Allergies: NKA
Diagnostic Lab Data: 08/07/21 2111 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/07/21 1109 | Final result | Specimen: COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: COUGH, FATIGUE, CONGESTION AND RUNNY NOSE Contact with and (suspected) exposure to covid-19 Fatigue, unspecified type Cough Acute pharyngitis, unspecified etiology


VAERS ID: 1583100 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-02-11
Onset:2021-08-03
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, COVID-19, Cough, Fall, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid Text
CDC Split Type:

Write-up: Positive Covid Test , unremembered fall, low oxygen levels, cough.


VAERS ID: 1586785 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Electrocardiogram abnormal, Hyperhidrosis, Loss of consciousness, Muscle rigidity, Presyncope, Pyrexia, Seizure, Tension, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Severer nut allergy
Diagnostic Lab Data: Saw pediatrician on August 5th. EKG results indicated a minor anomaly but was normal for child''s age according to pediatric cardiologist. Neurological assessment by pediatrician was normal. No evidence of concussion observed by parent or physician. Appointment for EEG is scheduled for September 9, 2021.
CDC Split Type:

Write-up: Ran fever overnight. Child woke and complained of extreme hunger pangs. Went vasovagal and had a seizure at 10:30 AM, 20 hours after the second shot. Child''s body was rigid and tensing for 45-60 seconds, eyes open and fixed. Fever recorded at 100.6? at time of event. Pulse was 193 BPM measured 1 minute after child regained consciousness, returning to 73 BPM 5 minutes after regaining consciousness. Child was sweating and clammy to the touch. At 15 minutes, gave apple slices and Gatorade Zero which was vomited minutes later.


VAERS ID: 1586788 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Fatigue, Injection site pain, Joint stiffness, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pill
Current Illness: None
Preexisting Conditions: Anxiety, depression
Allergies: Allergic to: penicillin, amoxicillin, keflax Sensitive to: wheat, egg whites, white mushrooms, chicken
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme soreness of whole muscle at injection site, intense red flushing of both cheeks on face, fatigue, whole body muscle weakness and joint stiffness/achiness


VAERS ID: 1586826 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-29
Onset:2021-08-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: SARS-CoV-2 test positive, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Arava, Plaquenil, Celebrex, Cymbalta, Topamax, Flexeril, Norco, vitamin D, calcium, anastrozole, B12, losartan, metoprolol, ASA, Benadryl, MVI, B6
Current Illness:
Preexisting Conditions: RA, Breast cancer
Allergies: Sulfa, latex
Diagnostic Lab Data: Additionally, patient had positive COVID nasal swab (don''t know method) on 8/17
CDC Split Type:

Write-up: Hives all over body, onset 4 days after vaccine, persisted at least 2 days, had resolved at time of telephone followup on 8/11


VAERS ID: 1586956 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Exposure during pregnancy, Heart rate increased, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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: I don''t remember what it was, maybe Tdap-anxiety kicking in I got dizzy and felt like I was going to pass out right after but no
Other Medications: Prenatal
Current Illness: No
Preexisting Conditions: Asthma
Allergies: I''m allergic to sulfur and latex
Diagnostic Lab Data: None so far. Bood pressure, pulse check, normal doctor''s office checks.
CDC Split Type: vsafe

Write-up: After I had started getting heart palpitations about 1 every 5 days after the 1st dose. After the 2nd dose they started every 2-3 days after couple of days after the vaccination. And then went daily by the time I went to my OB on August 11th. The symptoms I experience are heart palpitations, increased heart rate, pulse and dizziness. I get shortness of breath with the heart palpitations and increased heart rate. As time goes on it becomes more symptoms, now its a cluster of the symptoms where in the beginning it started with just heart palpitations. This is my 8th pregnancy and I''ve had 3 live births and so far this one is going well. I''m currently at 24 weeks. Estimated date of delivery is Dec. 10th 2021. No other complications. I was sent to see the Cardiologist on August 31st.


VAERS ID: 1587093 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Diarrhoea, Electrocardiogram abnormal, Headache, Myalgia, Pyrexia, Sleep disorder, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness:
Preexisting Conditions: Permanent thyroid issues do to total thyroidectomy after thyroid cancer.
Allergies:
Diagnostic Lab Data: Full blood panel completed ? my only abnormality was low WBC which my doctor says is normal after being vaccinated. EKG completed ? I had some arrhythmia after receiving the vaccine that has now let up. The EKG showed proof of a slowed heart beat. Doctor said diarrhea was nothing to worry about?
CDC Split Type:

Write-up: After the initial fever, muscle aches, and headache subsided about 48 hours after receiving the one-shot vaccine, the chronic diarrhea remained. I have never suffered from diarrhea, only constipation in the past. Now I have diarrhea several times a day, it even wakes me up at night. My diet is clean (fruits, veggies, grains, vegan proteins) and I don?t drink coffee or alcohol. This started the day after receiving my shot and has not let up since (I am 17 days post vaccine now).


VAERS ID: 1587141 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Headache
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: Testosterone gel
Current Illness: None
Preexisting Conditions: None
Allergies: Nkda
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Persistent Headaches, occur every day since 72 hours after infection 2. Can treat with OTC meds but continue to be present


VAERS ID: 1587165 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Ear pain, Malaise
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Strong sensations of dizziness, ear pain and feeling overall unwell.


VAERS ID: 1587252 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-15
Onset:2021-08-03
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 - / -

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

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

Write-up: Patient hospitalized due to COVID-19. Patient fully vaccinated.


VAERS ID: 1590957 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 09D1A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Abdominal Pain-Medium, Systemic: Fever-Medium, Systemic: Headache-Severe, Systemic: Nausea-Severe


VAERS ID: 1591168 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-09
Onset:2021-08-03
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer on 3/9 and 3/30. Positive on 8/18 admitted 8/18-current


VAERS ID: 1591182 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (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: Muscle twitch for over 2 weeks at site of shot on left arm.


VAERS ID: 1591223 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Dysphagia, Hypoaesthesia, Myasthenia gravis
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Immune-mediated/autoimmune disorders (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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Levofloxacin and Edrophonium chloride - exacerbates myasthenia gravis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received 1st dose of Pfizer vaccine on 08/03/2021. Then his Myasthenia Gravis symptoms started worsening compared to his baseline symptoms on 8/8/21, with more symptoms occurring earlier in the day. Also with some jaw numbness. He started himself on a liquid diet due to dysphagia and slowly was titrating up his prednisone. He last took his Xarelto 4-5 days ago due to running out of his prescription and having trouble obtaining a refill. Pt was admitted to hospital on 08/19/2021 with Myasthenia Gravis Acute Exacerbation.


VAERS ID: 1591664 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-08-03
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anal incontinence, Asthenia, COVID-19, Dysstasia, Gait inability, Peripheral swelling, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen prn, alendronate, alprazolam prn, apixaban, lidocaine-prilocaine 2.5% topical cream once prior to port access, ondansetron prn, pantoprazole, promethazine prn, tramadol prn
Current Illness:
Preexisting Conditions: Pancreatic cancer on chemotherapy, brain aneurysm, HTN, PE
Allergies: NKDA
Diagnostic Lab Data: SARS CoV 2 PCR COVID-19 Positive on 8/3/2021
CDC Split Type:

Write-up: 8/1/2021: Patient is a 71-year-old female with PMH of pancreatic cancer, HTN, PE, brain aneurysm, vertigo, osteoporosis who presented to the ED with reports of severe weakness and fecal incontinence. She reports that she was at home today and had an episode of fecal incontinence following which she was unable to stand and ambulate due to weakness. She was brought by EMS to the ED. She denies any urinary incontinence, but does report swelling of BLE. 8/3/2021: Tested positive for COVID following preprocedural COVID-19 saliva testing. Of note, patient was previously vaccinated with Pfizer COVID-19 Vaccine, last dose in April 2021. 8/16/2021: Patient still admitted at the time of this report PMH: Pancreatic cancer dx 11/2020 on chemotherapy, brain aneurysm s/p clip, HTN, PE on Eliquis, vertigo osteoporosis PSH: ORIF R hip/femur 4/18/2021, Whipple procedure 11/2020, appendectomy, port placement SH: former smoker, occasional beer.


VAERS ID: 1591710 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-14
Onset:2021-08-03
   Days after vaccination:111
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Exposure to SARS-CoV-2, Myalgia, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, CAD
Allergies:
Diagnostic Lab Data: Novel Coronavirus PCR- Detected 8/3/2021
CDC Split Type:

Write-up: 57 yo male s/p full Pfizer vaccination: dose 1 on 3/24 and dose 2 on 4/14. On 8/3 patient reports new onset chills, cough, SOB/difficulty breathing, muscle/body aches, and congestion/runny nose. He confirms close contact with a COVID+ individual. COVID PCR test resulst positive on 8/3. Patient receives casirivimab/imdevimab infusion on 8/4.


VAERS ID: 1591712 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-08-03
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Myalgia, Nasal congestion, Pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Novel Coronavirus PCR- Detected 8/3/2021
CDC Split Type:

Write-up: 52 yo female s/p full COVID Pfizer vaccination: dose 1 on 3/19, dose 2 on 4/9. Pt reports new onset cough, muscle/body aches, new loss of taste/smell, and congestion/runny nose on 8/3. Denies known exposure to COVID-19. PCR test results positive on 8/3. Patient receives casirivimab/imdevimab infusion on 8/5.


VAERS ID: 1591819 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-11
Onset:2021-08-03
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Chills, Cough, Decreased appetite, Diarrhoea, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Headache, Lung opacity, Myalgia, Nausea, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive, Serum ferritin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: n/a
Preexisting Conditions: anxiety, HLD, GERD, Leiden Factor 5
Allergies: NKDA
Diagnostic Lab Data: SARS CoV 2 PCR COVID-19 Positive on 8/3/21 as per patient
CDC Split Type:

Write-up: 8/8/2021: Pt presents with SOB, COVID +. States she was out of town with her fiance and had a known COVID exposure so she got tested outpatient and ended up testing positive with her fiance on 08/3/2021. Reports having symptoms of a cough, nausea, diarrhea, fevers (reaching 103 that she states have been better), chills, myalgias, decreased appetite and headaches. Reports having generalized fatigue and intermittent shortness of breath over the last several days but she SOB started worsening last night with worsening fatigue/weakness this morning. Reports her oxygen saturations at rest were ranging from 90-91% at home and would drop in the 80s with activity or coughing spells. She states she currently has


VAERS ID: 1592095 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma
Allergies: penicillin products
Diagnostic Lab Data: EKG done at ER 8/3
CDC Split Type:

Write-up: fainted & fell to the floor while waiting in the pharmacy "waiting area" post vaccine - within minutes of getting the dose. had to be taken by Ambulance to the ER where they did EKG testing, etc before releasing us to go home - we got home about 3 hours after the incident 1st took place


VAERS ID: 1592542 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast feeding, Chest pain, Dizziness, Headache, Hypoaesthesia, Hypoaesthesia oral, Influenza like illness
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Gluten
Diagnostic Lab Data: I did not have any tests done but my daughter tested negative for any respiratory illnesses.
CDC Split Type:

Write-up: Within 10 minutes of receiving the vaccine, I felt that I was going to pass out. I had to sit down on the floor in pharmacy. Within the next few hours, I experienced mild chest pain , mild to moderate head ache, and flu like symptoms. In addition, most of the left side of my face went numb like Bell?s palsy (forehead, cheek, lips and tongue on the left). I got the vaccine on a Tuesday. On Wednesday and Thursday my 10 month old breastfed baby started experiencing hives on her face and body. Her ears were red on the tips. Her hands and fingers were red and swollen hot to the touch. I took her to urgent care where she got an oral steroid. She tested negative for any respiratory virus. It is now a few weeks later and I still have a spot on the left side of my lips with no feeling. I am experiencing extreme fatigue where it is difficult to stay awake throughout the whole day.


VAERS ID: 1592563 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein increased, Chest discomfort, Chest pain, Confusional state, Electrocardiogram abnormal, Headache, Sinus bradycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Amlodipine, L-Arginine, DEHA, Omega 3, and chewable low dose aspirin
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: Total CK blood results that were taken on 8/19/2021 were high and the value was 301. EKG was performed on 8/20/2021 and showed Sinus Bradycardia
CDC Split Type:

Write-up: Immediate feeling of heaviness in chest followed by dull pain in middle of chest that is still currently happening along with headaches and confusion


VAERS ID: 1593207 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Myalgia, Pain, Pneumonia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, zinc sulfate, Wellness Formula, Vitamin C
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Tested positive for Covid 19 on August 5, 2021
CDC Split Type:

Write-up: Chills, muscle aches, severe pain, low grade fever of 99.9F, cough, shortness of breath, crackles in lungs, pneumonia on day 12 of illness, being treated with prednisone for 12 days and zithromax for five with an albuterol inhaler being used 4 times a day.


VAERS ID: 1593215 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Dyspnoea, Heart rate increased, Myocarditis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (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), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methadone- 55mgs Methadone oral solution
Current Illness: None
Preexisting Conditions: None
Allergies: Nome
Diagnostic Lab Data: No test were taken. At the time, I assumed these to be normal side effects of the Moderna shot. I now know this was myocarditis as I am 32 years old Healthy and have never experienced any shortness of breathe, heart palpitations or sharp stabbing pains while breathing until 5 days after I received my first Moderna shot. I will not return for the second shot and will see a doctor for this concern
CDC Split Type:

Write-up: myocarditis- I am 32 years old. Have never had any issues. 5 days after receiving the Moderna shot, I experienced chest pain. A rapid heart beat, shortness of breath and a sharp stabbing pain in my back and chest


VAERS ID: 1593773 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-29
Onset:2021-08-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cellulitis, Electrocardiogram abnormal, Heart rate irregular, Injection site cellulitis, Migraine, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (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? No
Previous Vaccinations:
Other Medications: Spironolactone
Current Illness: No
Preexisting Conditions: PCOS
Allergies: Hydroquinone
Diagnostic Lab Data: Electrocardiogram normal showing partial blockage on the right side.
CDC Split Type:

Write-up: Tachycardia, irregular heart beats, migraine, rush that looked like cellulitis near the site of the shot and in the hand of left arm, weakness. This lasted for one week and then mitigated. The rush disappeared completely. The heart rate has not yet normalized entirely.


VAERS ID: 1595982 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Medium


VAERS ID: 1602746 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 1 LA / IM

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

Write-up: Systemic: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash Generalized-Mild, Systemic: Chills-Mild, Systemic: small rash/bumps on lower left arm and a few bumps on chin-Mild, Systemic: Headache-Mild, Additional Details: small bumps on lower arm and some on face after a few hours and had chills and headache. pt took some benadryl at home and reported symptoms getting better the next day


VAERS ID: 1602844 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Odynophagia, Oral pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Patient said after second dose of Moderna, he experienced soreness on the roof of his mouth. It was painful to swallow. He did not experience any adverse events after the first dose. Advised him that if it get''s worse, he needs to go see his doctor.


VAERS ID: 1617368 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hot flush, Injection site rash, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily: Losartan 50mg; B12 1000mcg; D3 4000 IU
Current Illness: None
Preexisting Conditions:
Allergies: Sulfa meds
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache; chills; muscle aches; fatigue; hot flashes without fever; rash at injection site.


VAERS ID: 1617476 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-21
Onset:2021-08-03
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Elongated period, cramps, excessive bleeding. I have had my period for a month now


VAERS ID: 1617720 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7486 / 2 LA / IM

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

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

Write-up: patient received vaccine. was asked to wait 15 minutes. patient fainted then came to. patient fainted again then came to, fainted a third time came to. we called 911. Paramedics came and found no health concerns. ran EKG it was normal. they checked blood pressure. found to be normal. they said there was no reason for patient to to hospital. patinet sat alittle longer and went home with her mother


VAERS ID: 1620489 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-04
Onset:2021-08-03
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Headache, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: After two months I started with muscle pain, headache and vomit


VAERS ID: 1623348 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-28
Onset:2021-08-03
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5183 / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood lactic acid, Body temperature increased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Condition aggravated, Gastrostomy, Grunting, Hypoxia, Lung infiltration, Moaning, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: rosuvastatin, carvedilol, baclofen, amlodipine, clopidogrel, mupirocin 2% ointment topical
Current Illness: unknown
Preexisting Conditions: CVA, hypertension, hyperlipidemia, arthritis, dysphagia, gallstones
Allergies: NKDA
Diagnostic Lab Data: 8/3/2021: SARS CoV 2 PCR COVID-19 Positive
CDC Split Type:

Write-up: 8/3/21 Admitted to hospital. Breakthrough COVID : PMH of CVA and is noncommunicative, from a skilled nursing facility. She was noted to be moaning and grunting more than usual and was noted to be hypoxic and sent to the WP ER. COVID-19 +. CRP is 266.4. Lactic acid is 1.2. Chest x-ray shows diffuse pulmonary infiltrates compatible with pneumonia. She is started on remdesivir and dexamethasone. She has PEG tube in place. Her temperature was 102.6 yesterday. Patient received Pfizer COVID-19 vaccine, last dose January 2021. 8/12/2021: Patient discharged to SNF


VAERS ID: 1623585 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-07-26
Onset:2021-08-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE, METOPROLOL. IRBSARTAN. FENO FIBRATE
Current Illness: NONE
Preexisting Conditions: HIGH BLOOD PRESSURE HIGH COLESTEROL
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: RASH SPREADING OVER 30-40% OF MY BODY


VAERS ID: 1623809 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Lymphadenopathy, Pain, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rosuvastatin multi vitamin coq-10 asprin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: heart racing, headache, fever, body ache, lymph nods swollen


VAERS ID: 1623827 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest pain, Fall, Hyperhidrosis, Loss of consciousness, Mydriasis, Pallor
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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram 10mg Fenofibrate 145mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Collapsed 15 minutes after vaccine, entire body broke out in a sweat (looked as if I got out of a pool), blood pressure rose to 280 / 140, turned pale, eyes dialted and chest pains. I was out for about 10 minutes and apparently was clutching my chest while being revived.


VAERS ID: 1623847 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-26
Onset:2021-08-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthritis, Condition aggravated, Hyperaesthesia, Musculoskeletal stiffness, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Arthritis flare up in right hand. Severe swelling at knuckles with stiffness and pain making hand unusable and extremely sensitive to touch. After 10 days some lingering stiffness in finger joints but swelling and pain gone. Took Tylenol at night to sleep. Never had an incident like this before even though arthritis diagnosed from X-ray about 5 years ago.


VAERS ID: 1623896 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Called pediatrician, advised to report to office if ulcerations were to become infected. They did not become infected.
CDC Split Type:

Write-up: 24 hours later, broke out in rash on back, arms, fingers and toes, They appeared to looks like raised fluid filled bumps. 3 days later, the bumps burst and turned into larger ulcerations. I have photos I am happy to share.


VAERS ID: 1623970 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Movement disorder, Muscular weakness, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: I have not gone to a medical facility or doctor. Hoping this goes away.
CDC Split Type:

Write-up: Over the past two weeks I have experienced pain and some weakness along my left arm. I have lost some motion which I at first thought was a shoulder problem, but with no other precipitating event that I am aware of. The pain comes and goes and seems to be the same type of pain as I might describe sciatica, only from my shoulder down my left arm.


VAERS ID: 1623993 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-25
Onset:2021-08-03
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM6198 / 2 - / IM

Administered by: Work       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine, atorvastatin, metformin, omeprazole, aspirin; Fish oil, insulin pump, Jardiance, sildenafil, Vitamin D3, testosterone enanthate
Current Illness: no
Preexisting Conditions: Diabetes, HTN, Hyperlipidemia, Hypothyroidism
Allergies: Morphine
Diagnostic Lab Data: SARS COV Ag Positive on 7/29/21 Repeat Covid Test Negative on 8/12/21
CDC Split Type:

Write-up: 7/29/21: He noticed he started coughing and went to the walk in clinic on 7/29/21 and his Covid test resulted in positive on 7/29/21. At that time, he was instructed to monitor outpatient. 8/3/21: His symptoms were not improving. He came to Hospital on 8/3/21 and was hospitalized. He was discharged the following day 8/4/2021. Note: He had COVID Pfizer vaccines at his work on 03/04/2021 and 03/25/2021.


VAERS ID: 1624092 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Headache, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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 known
Current Illness: None known
Preexisting Conditions: Patient was born premature and had anemia issues as an infant. These have been resolved since infancy.
Allergies: None known
Diagnostic Lab Data: Blood glucose: within normal limits
CDC Split Type:

Write-up: Patient has experienced intermittent dizziness, headaches, and severe vertigo since the time of vaccine. Patient did not present the symptoms at any point prior to vaccination. Patient sought treatment from his primary MD and was prescribed meclizine to relieve vertigo symptoms and instructed to continue taking ibuprofen/acetaminophen and to report back if symptoms had not resolved after 1 - 2 weeks for full work up. Patient had blood glucose within normal limits and was well-hydrated.


VAERS ID: 1624135 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LL / IM

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

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

Write-up: The patient MAY have received a dose of Janssen vaccine that was administered after the Beyond Use Date. The provider may have given the dose outside of the 6 hour window after the vial was opened. No symptoms or signs. Pt will be contacted and offered to be re-vaccinated to offer full protection, per our Medical Group.


VAERS ID: 1624208 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

Write-up: The patient MAY have received a dose of Janssen vaccine that was administered after the Beyond Use Date. The provider may have given the dose outside of the 6 hour window after the vial was opened. No symptoms or signs. Pt will be contacted and offered to be re-vaccinated to offer full protection.


VAERS ID: 1624832 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-02-12
Onset:2021-08-03
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1111-20-EL3247 / UNK RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1111-20-EN6201 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Hypertension, Pyrexia, Urine analysis, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: 8/3/21 - Hospital - Urinalysis, Blood Tests, XRay for patient.
CDC Split Type:

Write-up: Fitness watch alerted to BPM above 130 at 8:10 am just after started drinking first cup of coffee on 8/3/21. Called Kaiser, who advised to call emergency number. Firetruck arrived, recorded 168 BPM, then ambulance arrived, hung IV prior to transport to emergency room. Symptoms gone prior to arrival at ER, and unable to find cause of high BPM, discharged me at 3:30 pm same day. Ran blood and urine tests, some values out of range. Fitness watch had also alerted high BPM on 7/31/21 at about 9:00pm, but high BPM did not persist. But from 7/31 - 8/3, I was running a fever of unknown origin.


VAERS ID: 1624835 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
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 both moderna COVID-19 vaccines on 03/29/2021 and 04/26/2021 respectively. Patient denied receiving any dose COVID-19 vaccine prior to vaccinating with Janssen COVID-19 vaccine on 08/03/2021. Pharmacist found out about moderna COVID-19 vaccines while documenting the vaccine administration. Patient didn''t return any phone call.


VAERS ID: 1624850 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Cardiac flutter, Chest pain, Electrocardiogram normal, Head discomfort, Menstrual disorder, Myalgia, Pain in extremity, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tachyarrhythmia terms, nonspecific (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B-12
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I called my MD on Thursday 8/5 in the morning to make an appt. I was told my MD was booked up until September. I was told they would relay my information to the doctor and I would get a call back. I waited 48 hours. No call back. I called my MD again on Monday 8/9 letting them know I did not recieve a phone call back. I was able to make an appt. with the nurse practitioner for Wednesday. I went in Wed. 8/11 for an appt. Told the nurse practitioner of my reactions to the shot. He took my vitals, listened to my heart, had an EKG done in office (normal result) and ordered bloodwork. I completed the bloodwork ( on Wed. 8/18. Awaiting results. Put in a phone call to my MD asking for results on Monday 8/23. Awaiting bloodwork results and recommendation.
CDC Split Type:

Write-up: 3-5 minutes after receiving injection I felt a heart fluttering. Very short. Maybe 5 seconds. The rest of the 15 mins went uneventful. After returning home I had 4 other heart palpitation experiences within the first couple hours. The palpitations each lasted less then 10 seconds in duration. Within the first 24 hours I also felt pressure in the back of my head on the left lower side. It wasn''t pain, or a headache but pressure. I also had pain in my arm (which I know is normal) and pain in my left armpit. I also started menstration within the first 5 hours of the shot even though my period was not expected for another 5 days ( and I am NEVER that early---my periods are regular! This was only 22 days since my last menstration!). The next 2 days I had pressure continue on the back of my head. Some pain in my chest and muscle pain in my upper back.


VAERS ID: 1628123 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, Joint stiffness, Joint swelling, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Swollen and stiff joints in hand of the arm vaccine was administered in right after vaccine was given. Has gotten better with only 2 fingers still stiff. Pt''s MD has advised her to take Motrin and that the stiffness will eventually subside.


VAERS ID: 1628260 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-26
Onset:2021-08-03
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Fatigue, Headache, Malaise, Nasal congestion, Respiratory tract congestion, SARS-CoV-2 test positive, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ventolin; Advair; Aspirin; Cromolyn, Daily multi vitamin; Zyrtec; Nasal Crom; Flonase; Fish oil, Levothyroxine, Calcium, Pepcid, Mucinex, Metoprolol, HCTZ; Simvastain, Lisinopril
Current Illness: none
Preexisting Conditions: hypertension dyslipidemia, persistent asthma, GERD; OSA, thyroid nodule,
Allergies: Norvasc; Cardizem
Diagnostic Lab Data:
CDC Split Type:

Write-up: not feeling well since early August, tested negative for COVID on 8/5/21. Continued to not feel well, tested positive on 8/22/21 cough, nasal congestion, chest congestion, headache, chills, wheeze, fatigue.


VAERS ID: 1628273 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-27
Onset:2021-08-03
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, C-reactive protein increased, Cardiac function test normal, Ejection fraction normal, Myocarditis, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Cardiac failure (broad), Myocardial infarction (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cetirizine 10 mg oral tablet, 1 tablet, ORAL, qHS (each night at bedtime) clonazePAM 1 mg oral tablet, 1 tablet, ORAL, BID (2 times a day), PRN, 2 refills Complete Natal DHA oral kit, See Instructions DULoxetine 60 mg oral delayed release c
Current Illness: n/a
Preexisting Conditions: +ANA, PCOS, obesity, iron deficiency anemia, hypothyroidism, bilateral knee OA, anxiety, insomnia, chronic joint pain
Allergies: sulfa drugs
Diagnostic Lab Data: Acute myocarditis onset 8/3/21 requiring hospitalization for 1 day. Elevated troponin, sedimentation rate, C-RP, and BNP. Normal LVEF and cardiac function. Evaluated by cardiology. Started on beta blocker. Resolved w/o residual sequalae.
CDC Split Type:

Write-up: Acute myocarditis onset 8/3/21 requiring hospitalization for 1 day. Elevated troponin, sedimentation rate, C-RP, and BNP. Normal LVEF and cardiac function. Evaluated by cardiology. Started on beta blocker. Resolved w/o residual sequalae.


VAERS ID: 1628312 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Condition aggravated, Dystonia, Hypoaesthesia, Immediate post-injection reaction
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dystonia (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Neurological
Preexisting Conditions: Neurological
Allergies: Naproxen, diclofenac, latex
Diagnostic Lab Data: Blood test 8/4/2021
CDC Split Type:

Write-up: A lot of pain on left elbow then numbness seconds after shot on lwft forearm and top of hand, then 3am next day numbness on left leg. This triggered my Dystonia. Treatment IV and valium. Outcome got released from hospital with left arm and left leg still numb and 21 days latter my left arm and left leg still numb, maybe only 25% better.


VAERS ID: 1628359 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site mass, Limb discomfort, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (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: Lo loestrin fe
Current Illness: No known illness
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data: Have not seen a doctor about it.
CDC Split Type:

Write-up: Had left arm discomfort after vaccine that continued for about 17 days. Started to message my arm one day to help with the pain and noticed a pea sized lump on my upper arm medial side. Have not had arm pain in the last 3 days but the lump is still there - size is the same I believe. Received second dose of Pfizer yesterday (8/23/21) on opposite arm.


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