National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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 293 out of 7,116

Result pages: prev   194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392   next


VAERS ID: 1523126 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Muscle tightness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (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 reported
Current Illness: none
Preexisting Conditions: none; patient reported he was "borderline hypertensive"
Allergies: no known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: At 1615, patient reported tightness in shoulders and back of neck. Patient reported similar episodes when he is nervous. Patient assisted into anti-gravity chair. Patient stated he "feels like I''m going to throw up" and reported "feels like I''m going to black out". Patient offered emesis bag and water. Patient denied itchiness, rashes, hives, difficulty swallowing and difficulty breathing. At 1620, RN assessed patient vital signs: 122/78 mmHg and pulse 72 beats/minute. Patient reported history of being "borderline hypertensive", no chronic conditions, and no current medications. At 1621, patient stated his symptoms were "going away". At 1635, RN reassessed patient vital signs: blood pressure 118/80 mmHg and pulse 75 beats/minute. At 1639, patient denied nausea, vomiting, and reported less tension in shoulders and back of neck. At 1644, RN reassessed patient vital signs: blood pressure 124/80 mmHg and pulse 73 beats/minute. Patient reported he is feeling "good" and "okay" to drive. RN educated patient on signs/symptoms of when to seek emergency care, to follow up with primary care provider and to sign up on v-safe. At 1646, patient left facility with unlabored respirations and steady gait.


VAERS ID: 1523129 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: Pt walked in for her 1st Covid shot as Janssen. It was given on 8/2/21. but it was 3rd shot . She received Pfizer vaccine on 5/8/21 at a pharmacy and 7/27/21 at another pharmacy. I found out when I do reports at the end of the day. She confirmed it to me finally today morning on 8/3/21 (9am). She doesn''t have any side effects at this point, but I am reporting for her unauthorized 3rd vaccine.


VAERS ID: 1523130 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-03
Onset:2021-08-02
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 2 - / SYR

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

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

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


VAERS ID: 1523134 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-05
Onset:2021-08-02
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 - / -

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

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: Vaccine #1 04/09/2021 Lot # EW0162


VAERS ID: 1523136 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram, Diarrhoea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Emergency CT scan and ER visit after second shot. Severe abdominal pain
Other Medications: Prozac Pepcid Vitamin D Iodine Birth control Omeprazole Zyrtec Miralax
Current Illness: IBS Anxiety Disorder
Preexisting Conditions: IBS Anxiety Disorder PTSD
Allergies: General environmental allergies but no anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Entirely liquid diarrhea after second shot. Stopped taking Miralax even though I need it to be able to go to the bathroom.


VAERS ID: 1523140 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-02-19
Onset:2021-08-02
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Obesity (BMI greater than 50.9)
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated with Pfizer COVID-19 vaccine on 01/29/2021 lot# EN5318; and second dose Pfizer COVID -19 vaccine on 02/19/2021 lot# EN6200. Contracted COVID-19 on 8/2/2021 with mild symptoms.


VAERS ID: 1523146 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-11
Onset:2021-08-02
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 - / -

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

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: Vaccine #1 12/22/2021 No lot #


VAERS ID: 1523156 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-08-02
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

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

Write-up: Pt tested positive for COVID after being fully vaccinated.


VAERS ID: 1523179 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Vaginal haemorrhage
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: Hbp meds, 81 mg aspirin, vitamins b, c, d, zinc
Current Illness: High blood pressure
Preexisting Conditions: Hbp
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I''m 50. After having no period for over 1 year, I got it after taking 1st Moderna dose. First spotting and then heavier than my old cycles.


VAERS ID: 1523181 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Hypotension, Loss of consciousness, Memory impairment, Pallor, Paraesthesia, Photopsia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Retinal disorders (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Within 2 minutes of receiving the vaccine, the patient complained on dizziness, bright lights in vision, and tingling in both hands. His color was pale. He was responsive, he recited his name and location. I gave him a bottle of water to sip on and a chair to sit. Within 2 minutes, the patient passed out. His head slumped forward, did not fall out of chair. I immediately took his pulse, it was strong. I shook his shoulder and spoke loudly calling his name. He perked up, looked at me but with no recollection, and was starting to sweat. I had a nearby technician call 911. He then passed out again, same presentation (slumped over, didn''t fall). I grabbed an EPI pen quickly, came back to check pulse (still strong), and shook him. He woke again without use of epi pen. EMS arrived at 2:55pm to further evaluate. They ruled out anaphylaxis and deemed this to be a hypotensive reaction to getting a shot. Patient started feeling better, and declined to go to the hospital for further evaluation. He waited in the pharmacy for 20 more minutes then drove himself home (he did say his mother was coming to sit at home with him just in case). I called him at 5pm to check on him and he reported no issues and doing ok. He will not be getting second shot.


VAERS ID: 1523195 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19 immunisation
SMQs:, 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: Not known.
Current Illness: Not known.
Preexisting Conditions: Not known.
Allergies: Not known.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: The patient came into the pharmacy as a walk-in for a COVID vaccination with a prefilled informed consent form. The technician asked the patient if this was his first vaccination shot and he answered yes. She proceeded to take a copy of his ID and insurance card. The technician then gave the prefilled form to the intern. Following usual procedures for vaccinations, the intern asked the patient if this was the patient''s first vaccination/Pfizer vaccination and talked to him about the side effects of the vaccine. Later on that afternoon, the technician was batch processing the Pfizer vaccines and noticed that the patient noted on the consent form that he had received a J&J vaccination on 03/30/2021. The pharmacist on duty called the patient to verify, and the patient stated "he got the J&J on 03/30/21. He did a blood test at the doctor''s office and the doctor told him that he does not have antibodies. The doctor recommended that he get revaccinated." The patient states that he will ask the doctor for the recommendation in writing and will bring it to the pharmacy once he gets the written note.


VAERS ID: 1523201 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fainting
Other Medications:
Current Illness: not any known
Preexisting Conditions: not any known
Allergies: amoxicillin, penicicilin, betalactams
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient was afraid of needles to begin with, she recived her vaccine and within 1 minute she felt dizzy and fainted for around 15 seconds, her color turned from pink to very paole, we called 911 and her bp was 110/60 and ok pulse, after waiting for 15 minutes she vomitted t wice and her father pickeed her up, she did not want to go hosptial


VAERS ID: 1523202 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-01-24
Onset:2021-08-02
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin 81 mg PO Clopidogrel 75 mg PO Hydrochlorothiazide-losartan 12.5 mg-50mg PO Ibuprofen 800 mg PO TID metformin 500mg PO BID simvastatin 80mg tramadol 50 mg BID Tylenol arthritis 500mg PO Ventolin HFA 90 mcg/inh 2 puffs q6hours xanax
Current Illness:
Preexisting Conditions: chronic back pain benign essential HTN CAD ECG abnormal s/p angioplasty with stent type 2 diabetes
Allergies: NKMA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted on 8/2 with fever and cough post completion of COVID vaccination series in February 2021. Diagnosed with COVID-19 and community-acquired pneumonia.


VAERS ID: 1523221 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Taste disorder
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: Before receiving the vaccine the patient appeared mildly nervous. A few minutes after receiving the vaccine the patient felt light headed, dizzy, short of breath, and reported a "funny" taste in her mouth which she was unable to describe. She reported feeling as though she had "taken too many vitamins." The patient was given a cup of water. Since it was apparent she was not experiencing anaphylaxis, the patient was advised to take deep inhalations/exhalations to help her relax. She then reported that she had not eaten anything yet that day. The pharmacist bought the patient bread from the next door bakery which the patient ate with another 2 cups of water. The patient was monitored for 30 minutes in the pharmacy. After the 30 minutes, the patient appeared to be breathing normally again and said she felt better. She was advised to eat a meal and was allowed to go home.


VAERS ID: 1523223 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH LOT: EW0175 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine Besylate 5 MG oral Tablet Take 1 tablet (5 mg total) by mouth daily Ascorbic Acid (VITAMIN C OR) Take by mouth BIOTIN OR Take by mouth Cholecalciferol (VITAMIN D3 OR) Take by mouth Coenzyme Q10 (CO Q 10 OR) Take by mouth COLLAGEN
Current Illness:
Preexisting Conditions: Morbid Obesity, Lymphedema, HTN, Prediabetes
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt denies any side effects on 8/3/21


VAERS ID: 1523227 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Paraesthesia, Urticaria, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Meperidine
Other Medications: Gummy multi-vitamin daily.
Current Illness: Lower extremity edema.
Preexisting Conditions: None currently
Allergies: Peanuts and others nuts, shellfish. Bee venom. Penicillin''s, Tramadol, Codeine, Tamsulosin, Meperidine, Oxycodone, Tetracyclines, Hydrocodone- Acetaminophen, Sulfa drugs, and Contrast Dye.
Diagnostic Lab Data: Diagnosed with paresthesia. Adverse reaction to vaccine per ER MD. None ordered while at ER visit 08/02/2021.
CDC Split Type:

Write-up: Began on 08/02/21 at 10:45pm. Experienced pins and needles sensation in my left hand that travel up my left wrist and arm to my left shoulder. Felt loss of strength in my hand and arm, shoulder. Pins and needles sensation left leg and foot. Facial hives developed on 08/03/2021. These symptoms continue 24 hours after first dose of the Pfizer vaccine on 08/02/2021.


VAERS ID: 1523228 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Nausea, Posture abnormal, Presyncope, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient began experiencing nausea and faintness approximately 2-3 minutes after vaccination. She had either a brief fainting episode or a near-fainting episode, and her head drooped while still sitting down. Patient''s mother was present and held her steady. Immediately after this episode, patient vomited on the floor. Patient was moved from an upright chair to a reclining chair and monitored for the next 30 minutes. She was given cold water and an ice pack for her forehead. Blood pressure was checked twice during monitoring and was 93/64 the first time, and approximately 112/74 before leaving. Patient reported feeling better but still tired and weak. She said this has happened to her once before with a flu shot, but it was "years ago." She also said she had not eaten since the morning that day. Upon leaving, she was accompanied to her mother''s car by her mother and aunt. Instructions given to the mother to report to ER or medical office if condition worsens.


VAERS ID: 1523254 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-23
Onset:2021-08-02
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Blood glucose, Blood magnesium, Computerised tomogram normal, Dizziness, Full blood count, Hypoaesthesia oral, Immediate post-injection reaction, Metabolic function test, Pregnancy test
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (broad), Vestibular disorders (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: I am always dizzy and light headed following mandatory flu vaccination. Every year I mention this and it is shrugged off.
Other Medications: Zyrtec, vitamin C
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin and sulfa
Diagnostic Lab Data: 8/2/21 - CBC, BMP, magnesium, pregnancy test, blood glucose, CT scan (negative)
CDC Split Type:

Write-up: I was immediately dizzy and light headed after vaccination which has continued off and on until present. On 7/26/21 the left side of my tongue went numb. On 8/2/21 I had full blown Bell?s palsy which required an emergency room visit and CT scan.


VAERS ID: 1523261 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Unknown  
Location: Washington  
Vaccinated:2021-02-01
Onset:2021-08-02
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / IM

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

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

Write-up: Breakthrough COVID Case


VAERS ID: 1523270 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-31
Onset:2021-08-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came in for his "1st Moderna shot" on Saturday 7/31/21. He calls on Monday 8/2/21 complaining of a very sore arm, much more sore than his 1st 2 shots. He admitted that he got 2 shots from a health facility, presented at the pharmacy stating he did not have insurance. Patient calls again on Tuesday 8/3/21 that his arm is in a lot of pain so I suggested he go see a MD about it sooner rather than later.


VAERS ID: 1523278 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Erythema, Hyperhidrosis, Influenza like illness, Oropharyngeal pain, Rash, Skin warm
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: buPROPion (75 mg) setraline (75 mg)
Current Illness: none
Preexisting Conditions: possible autoimmune disease (Lupus) - still currently under diagnostics
Allergies: amoxicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Broke out into a full body rash somewhere between 2-3 hours after the vaccine. I only noticed it about 3 hours after getting the shot. The rash started out on my chest and stomach, it looked like I had the chicken pox. And there were red and pink patches all over the rest of my body. I felt extremely warm, and was sweating profusely. My chest felt tight, and my throat hurt, but I had no trouble breathing. I went to bed after calling the hospital, where a lady told me I should be fine, and to call my provider in the morning. When I woke up the rash was almost completely gone. And my chest no longer felt tight, and my throat felt fine. I had a few patches of pink dots across my stomach. But after taking Benadryl today (8/3 at 9am), the rash is almost completely gone (current time:3:30pm). And other than typical Flu like symptoms, I feel fine.


VAERS ID: 1523296 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

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

Write-up: Patient called to report that upon arriving home after her vaccination, soon developed hives on bilateral lower extremities


VAERS ID: 1523310 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-26
Onset:2021-08-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Redness at site of injection, itchiness, nodules. Started on 8/2 (1 week after injection)


VAERS ID: 1523320 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Exposure to COVID19 confirmed family member . then tested for COVID the result came positive


VAERS ID: 1523393 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Unknown  
Location: Kansas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Injection site bruising, Injection site pain, Injection site swelling, Migraine, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt. states that after the 1st dose of J&J 08/02/2021, started experiencing at the injection site (swollen, blackish circle), extreme pain at the injection site, chills (shaking), fever (105.0), muscle aches, and extreme migraine lasting a couple hours. Preciously had a bad spell Covid +. Still experiencing symptoms, planning Primary visit.


VAERS ID: 1523435 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Device connection issue
SMQs:, Medication errors (broad)

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

Write-up: As I injected the needle into the patient the needle and syringe separated. The patient did not receive the vaccine that time. I redrew medication in new syringe and needle tip and gave patient the vaccine. Patient saw that they didn''t receive it initially so was ok


VAERS ID: 1523436 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Heart rate increased, Hypotension, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Malarone, Adderall, Cymbalta, Nystatin, Hydroxyzine, Prazosin
Current Illness: Lyme disease, babesia, bartonella
Preexisting Conditions: Lyme disease, babesia, bartonella
Allergies: Tegaderm skin allergy, vancomycin, neosporin, other topical creams, parabens.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have a history of POTS: low blood pressure and elevated heart rate, which includes dizziness, lightheadedness, and nausea. HOWEVER, my POTS symptoms had improved substantially, almost seeming to disappear, after doing a lyme disease treatment BEFORE I got the vaccine. Right after getting the vaccine, I developed what seemed to be a normal reaction to the second dose of the Pfizer vaccine that others experienced. But my POTS symptoms are now INCREDIBLY worse than they were before the second dose of the Pfizer vaccine. Since getting the vaccine I have had to start taking MIDODRINE, 10MG, 3X/DAY. While I had bad POTS symptoms YEARS AGO, I do not recall ever needing to take this much medication for such a long period of time because I felt so faint.


VAERS ID: 1523437 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension/ Hyperlipidemia, Atrial Fibrillation, Gout, CHF
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: None


VAERS ID: 1523440 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Patient had a cold, runny nose a week before vaccine.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient was supposed to get second dose of Pfizer vaccine and I gave him a Moderna vaccine.


VAERS ID: 1523442 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Blood glucose normal, Feeling hot, Head titubation, Hyperhidrosis, Malaise, Nervousness, Paraesthesia, Slow speech, Tinnitus, Visual impairment
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: obesity, eosinophilic esophagitis
Allergies: none known
Diagnostic Lab Data: Blood glucose level and blood pressure through the paramedics on 8/2/21
CDC Split Type:

Write-up: Patient was very nervous walking into the vaccination room with her mom and expressed worry but willingly agreed to the vaccination in the left arm. Prior to vaccine administration, we verified if she had ever had to use an EpiPen after getting vaccinated and after the patient said no, the vaccine was administered. Immediately after the vaccine, the patient was still anxious and asked for water which was brought to her. Right after drinking some water, she verbally expressed that she wasn''t feeling well and the pharmacist was called into the room and we called 911 at 11:57am. We brought over another chair for the patient to rest her legs and to be in a more comfortable position. The patient reported tingly fingers, seeing dots, hot and sweaty but not pale, had ringing in the ears, drifting, and her words were very slow. The paramedics arrived to the scene and tested her blood glucose levels and blood pressure which were normal. The paramedics made sure that the patient reported that she felt ok and left at around 12:20pm. Patient left comfortable to stand up and go home with her mother at approximately 12:30pm.


VAERS ID: 1523453 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

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

Write-up: pt came in and asked for 1 st dose of covid. after hours when billing admin fee found out pt had janssen shot in march.


VAERS ID: 1523461 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse event, Poor quality 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: Patient was given REFROZEN vaccine. No adverse events


VAERS ID: 1523471 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 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: Patient given REFROZEN vaccine. No Adverse events


VAERS ID: 1523489 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-22
Onset:2021-08-02
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: Started period 10 days earlier then expected & heavier flow then normal. Currently on day 2.


VAERS ID: 1523677 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-31
Onset:2021-08-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Retinal vein occlusion, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), 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: Aspirin 325mg Lisinopril 10mg Pravastatin Ocuvite Cardizem 30mg
Current Illness: Bactrim Elequis Zarelto
Preexisting Conditions: Fluctuating Hypertension
Allergies:
Diagnostic Lab Data: Retinal imaging 8-3-21
CDC Split Type:

Write-up: Extremely blurred vision secondary to a central retinal vein occlusion in the right eye.


VAERS ID: 1523906 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (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: Hydroxyzine 25 mg; Sertraline 100 mg: Trazodone 50 mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flushing, nausea, light-headedness


VAERS ID: 1523920 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion XL 150mg, Biktarvy
Current Illness: Strep throat
Preexisting Conditions: HIV infection
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient went to urgent care reporting symptoms of numb feet, light headedness/being dizzy, and blurry vision after receiving the covid-19 Moderna vaccine.


VAERS ID: 1524121 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Sudden hearing loss
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None my left ear went deaf today 8/3/21 @ 530 pm
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Shot to left arm at 250?pm 8/2/21 . Hearing suddenly gone by 5 pm. 24 hours later exactly almost the left ear did the same thing


VAERS ID: 1524321 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Syncope
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), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: auto immune deficiency
Preexisting Conditions: auto immune deficiency
Allergies: no known allergy
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient fainted after receiving the Covid 19 vaccine. The patient also reported not having eaten much during the day. The patient had not been unconscious for long and came to. The pharmacist and one other staff member had the patient lay on the floor with her feet elevated until she felt less dizzy. The patient was also given juice to drink. After approximately 25 minutes, the patient was able to get up and walk to go home


VAERS ID: 1524322 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-26
Onset:2021-08-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3 & Deva Vegan Multivitamin & Mineral Supplement
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At the point of injection, I have a large (approx 2 inch) raised bumpy and kind of hard lump on my arm. Sometimes it itches and it''s warm.


VAERS ID: 1524331 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F47484 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Blood test normal, Dizziness, Electrocardiogram abnormal, Feeling hot, Flushing, Heart injury, Heart rate increased, Paraesthesia, Respiration abnormal, Sensitive skin
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Respiratory failure (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Controlled asthma
Allergies: Codeine, penicillin, sulfa, morphine
Diagnostic Lab Data: Blood test good , no damage and EKG according to DR heart damage further investigation needed 8/2/2021 and Urgent care EKG normal 8/3/2021
CDC Split Type:

Write-up: With in 5 minutes flushed, heat through out my body, light headed or brief dizziness. Hyper feeling tingling in my hands. High BP and heart rate 181/101 HR 115. Not swelling throat but trying to breath deep enough. day 2 eve BP now 150-160


VAERS ID: 1524333 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202AZ1A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Condition aggravated, Fatigue, Hyperhidrosis, Migraine, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft Imitrex Botox for migraine
Current Illness: Chronic Migraine
Preexisting Conditions: Chronic migraine
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe body aches Fever 102.4 Chills Massive Migraine Sweats Fatigue Weak


VAERS ID: 1524334 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-25
Onset:2021-08-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyfemla (birth control); Post-natal vitamins
Current Illness: None
Preexisting Conditions: Endometriosis, Breastfeeding
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy raised rash on injection spot day after received and then appeared again 7 days later.


VAERS ID: 1524337 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer COVID vaccine incorrectly diluted with normal saline in multi dose vial with preservative. Correct diluent should be normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. Medical person called the morning of 08/03/21 and spoke to patient on the medical team at Pfizer who gave the same information. Patient was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline.


VAERS ID: 1524342 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. called the morning of 08/03/21 and spoke to the medical team at Pfizer who gave the same information. was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline.


VAERS ID: 1524347 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. Facility called the morning of 08/03/21 and spoke to staff member on the medical team at Pfizer who gave the same information. Staff member was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline.


VAERS ID: 1524351 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation 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: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. Hospital called the morning of 08/03/21 and spoke to the medical team at Pfizer who gave the same information. Was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline. No adverse events reported by patient.


VAERS ID: 1524355 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. Morning of 08/03/21 spoke to agent who gave the same information. Agent was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline. No adverse events have been reported by patient.


VAERS ID: 1524359 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

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

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

Write-up: about 5 mina fter receiving the vaccine the patient was sitting next to parent and fainted. Mother caught him. I went behind him to support him and it took about 5 min to fully recover


VAERS ID: 1524497 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Angina pectoris, Pain in extremity
SMQs:, Other ischaemic heart disease (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Possible food poisoning around July 3-4, 2021
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right arm very sore starting that evening. Soreness into the nest day. Heart pain. Today is only the second day abs his symptoms are bad enough to go to the doctor.


VAERS ID: 1524525 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye movement disorder, Vertigo
SMQs:, Vestibular disorders (narrow), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall xr 25mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after vaccine, experienced vertigo with rapid eye movement


VAERS ID: 1524811 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Delaware  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Electrocardiogram, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210802; Test Name: EKG; Result Unstructured Data: Not reported; Test Date: 20210802; Test Name: Blood pressure; Result Unstructured Data: Not reported
CDC Split Type: USJNJFOC20210802724

Write-up: SEIZURES; This spontaneous report received from a health care professional concerned a 22 year old. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown and expiry: unknown) dose was not reported, 1 total, administered on 02-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 02-AUG-2021, after the vaccination the patient experienced seizures, and also undergone blood pressure and Electrocardiogram (EKG) and was hospitalized for 1 day. The results for blood pressure and EKG were not reported. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of seizures was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210802724 -Covid-19 vaccine ad26.cov2.s-Seizures. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1524815 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality 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: USJNJFOC20210802774

Write-up: VACCINE ADMINISTERED 35 MINUTES AFTER 2 HOUR LIMIT AT ROOM TEMPERATURE; INCORRECT PRODUCT STORAGE; This spontaneous report received from a pharmacist concerned a 59 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 02-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-AUG-2021, the subject experienced vaccine administered 35 minutes after 2 hour limit at room temperature. On 02-AUG-2021, the subject experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered 35 minutes after 2 hour limit at room temperature and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1524819 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Wrong technique in product usage process
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: USJNJFOC20210802879

Write-up: USED SHORTER THAN RECOMMENDED NEEDLE LENGTH FOR ADMINISTRATION; This spontaneous report received from a pharmacist concerned a male of unspecified age. The patient''s weight was 294 pounds, and height was not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 02-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-AUG-2021, the subject experienced used shorter than recommended needle length for administration. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of used shorter than recommended needle length for administration was not reported. This report was non-serious.


VAERS ID: 1524821 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Maine  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210802915

Write-up: EXPIRED DOSE ADMINISTERED (VIAL WAS PUNCTURED AT 08:50 AND ADMINISTERED AT 15:10); This spontaneous report received from a consumer concerned a 34 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286, and batch number: 1821286 expiry: 21-OCT-2021) dose was not reported, administered on 02-AUG-2021 15:10 for prophylactic vaccination. No concomitant medications were reported. On 02-AUG-2021, the subject experienced expired dose administered (vial was punctured at 08:50 and administered at 15:10). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired dose administered (vial was punctured at 08:50 and administered at 15:10) was not reported. This report was non-serious.


VAERS ID: 1524830 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Off label use, Product administered to patient of inappropriate age
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: USJNJFOC20210803141

Write-up: ADMINISTRATION OF VACCINE TO INAPPROPRIATE AGE GROUP; OFF LABEL USE; This spontaneous report received from a health care professional concerned a 14 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 02-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-AUG-2021, the subject experienced administration of vaccine to inappropriate age group. On 02-AUG-2021, the subject experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of vaccine to inappropriate age group and off label use was not reported. This report was non-serious.


VAERS ID: 1525358 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dyspnoea, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: The patient was sitting in the observation area with his mother, when he began to feel short of breath and unexpectedly lost consciousness. The mother said he "slumped down in his chair". He came to within a minute, was laid down (and 911 was called immediately). He said he has never passed out from a vaccine before, but not longer felts out of breath or any other symptoms. A pharmacist (myself) retrieved a nurse and PA from the clinic across the hall who monitored the patient, who then had normal vitals. He denied the ambulance when they arrived and eventually left on his own accord.


VAERS ID: 1525360 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild


VAERS ID: 1525377 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052D22A / 1 LA / IM

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

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

Write-up: One hour after vaccination, patient states she developed a severe macropapular rash throughout the majority of her body, from her forehead to her calves. Photographs also seemed to reveal urticaria. She went to the urgent care and was treated with IV Benadryl and steroids. She was also prescribed oral Benadryl and corticosteroids. The rash and hives persisted throughout the ensuing 30 hours and was only mildly ameliorated with the meds. She presented to our ED at 2 AM on 8/4/2021 (31 hours post vaccination) and a physical examination revealed severe macropapular rash and hives throughout her forehead and stretching down to her thighs. Patient reported severe discomfort, itching and soreness. We treated her with 50 mg IV diphenhydramine, 125 mg IV methylprednisolone and 20 mg IV famotidine. The condition improved over the next three hours and she was discharged with instructions to continue taking the urgent care medications from the previous day and to return to the ED if symptoms worsened or failed to resolve.


VAERS ID: 1525609 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-02
Onset:2021-08-02
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 2 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, COVID-19, Chills, Cough, Dehydration, Dizziness, Fatigue, Gait disturbance, Headache, Impaired work ability, Influenza virus test, Loss of personal independence in daily activities, Malaise, Migraine, Motor dysfunction, Pollakiuria, Pyrexia, Sinus operation, Sneezing, Urine analysis, Vomiting, Weight increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: I had a burnt out and exhausted feeling on the first day around 7PM. Right around 10PM, I started getting really sick. I was urinating every half hour to an hour. I was checking my blood sugar and it was fine. I was having headaches. Lots of dizziness. I was having a lot of repeat symptoms. I was having sinus drainage, sneezing, and coughing. I had abdominal pain. I had fluid in my head. I had a fever and chills around 10PM. I was feeling very sick to my stomach. I wrote a note to my principal. I was experiencing fever (99-100), trouble holding down most of my food, headache, nausea, and chills. I was given a shot of Toradol at the clinic. They ran a flu and COVID test. The doctor said it could also be related to the vaccine. I was shivering really bad. I was having problems with my motor functions. I was really having a bad time walking around. I almost fell a few times. I was really bad off. I was having excessive migraines. The exhaustion was unreal. Around 10:15am, I was still feeling some exhaustion. I still had stomach problems. I was throwing up really bad. I threw up so much that I filled a 3-gallon bag. It was very violent. Once I got to urgent care, they ran a UTI test. They tested me for all kinds of viruses. I was having abdominal pain. I was quarantined. They said I had a drug induced fever. This has been life changing for me. My wife has to kind of help me around the house. I have trouble typing now. This has caused a ton of stress. I still check my blood sugar every day. I am struggling with my weight. I was at 235lbs before the vaccine, but after I am now at 270lbs. I was barely eating because I couldn''t keep anything down. I was shivering really bad and very dehydrated from throwing up. I drank Pedialyte a few times because I couldn''t keep regular food down. I received a letter from concern from my principal. I have dealt with so much stress from it affecting my career. I have had to talk to the management and HR. I am still having abdominal issues.


VAERS ID: 1525639 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Dyspnoea, Fatigue, Headache, Insomnia, Mobility decreased, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: No reported illnesses
Preexisting Conditions: Has Cancer- Not known which kind
Allergies: No allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: He reports symptoms starting at 7pm on Monday 8/2. reports itching all over his body, feeling very tired, can''t sleep, has a headache off and on, has sharp pains that are short in the abdomen and head, couldn''t get out of bed to walk the dog, short of breath


VAERS ID: 1525659 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Hypoaesthesia, Laboratory test abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nitrofurantoin
Current Illness:
Preexisting Conditions: Crohns, asthma, migraine
Allergies: Monistat, dogs, cats, grass
Diagnostic Lab Data: Seen in ED the day of onset (8/2/21). Do not have ED report at this time. Pt reports labs and CT done and were all normal.
CDC Split Type:

Write-up: 72 hours after vaccination developed tingling/numbness in all 4 extremities. No motor sxs. Since onset sx''s have not progressed or regressed (about 72 hours now)


VAERS ID: 1525687 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       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:
CDC Split Type:

Write-up: It was discovered that the patient was 3.5 months under 18 years of age and she was given the Moderna vaccine which has only been approved for individuals 18 and over. The patient has had no adverse events due to this vaccine as far as we know.


VAERS ID: 1525717 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac discomfort, Defaecation urgency, Dizziness, Heart rate decreased, Hyperhidrosis, Hypotension, Nausea, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa Drug, Keflex, Raspberries
Diagnostic Lab Data: Within 10 min of vaccine on Aug 2nd nurse took vitals 59 bpm, 99%, 16, 98/58 manual left arm, 96.8 forehead. Approx 30 min after vaccine on Aug 2nd nurse rechecked vitals 99% RA, 76 bpm, 108/68 left arm, manual.
CDC Split Type:

Write-up: Recvd vaccine approx 12:45 pm and within 2-3 min began feeling nauseous, dizzy, like I was going to pass out. Broke out in a heavy sweat and felt like I was going to throw up and needed to have a bowel movement. Heart rate and blood pressure were abnormally low. Felt shakey and as if heart was racing even though heart rate was low.


VAERS ID: 1525719 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-08-02
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Asthenia, Blood glucose normal, C-reactive protein normal, Computerised tomogram head normal, Dizziness, Fall, Fatigue, Full blood count normal, Gait disturbance, Gait inability, Head injury, Human chorionic gonadotropin negative, Limb discomfort, Magnetic resonance imaging spinal normal, Magnetic resonance imaging thoracic normal, Metabolic function test normal, Red blood cell sedimentation rate normal, SARS-CoV-2 test negative, Sensory loss, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA, NKFA
Diagnostic Lab Data: BMP, CBC, B-HCG, BG, ESR/CRP, & COVID - all negative; CT brain - normal; Thoracic and Lumbar MRI - normal.
CDC Split Type:

Write-up: Syncopal episode (dizziness, lightheaded, and fainted) - fell backwards and hit her head on the floor, cannot remember what happened after that incident, took 5-25 minutes to become responsive again. Was unable to walk afterward and had to be carried to the hospital. Also decreased strength in bilateral upper and lower extremities, legs feel heavy, decreased sensation to legs, very slow gait, very tired


VAERS ID: 1525763 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-20
Onset:2021-08-02
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: not known
Preexisting Conditions: not known
Allergies: not known
Diagnostic Lab Data: positive PCR for Covid on 8/2
CDC Split Type:

Write-up: Client vaccinated with Pfizer vaccines for Covid on March 20 and April 20 2021. Became symptomatic for Covid on 8/2 and tested positive PCR for Covid on 8/2/2021. Reported as a breakthrough Covid case in a fully vaccinated person.


VAERS ID: 1525764 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Hypoaesthesia, Immediate post-injection reaction, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: immediately she felt dizzy, chills, nausea and fever by bedtime. Left arm was painful. She took Tylenol then developed numbness down her arm.


VAERS ID: 1525787 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

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

Write-up: dizzy, vertigo


VAERS ID: 1525800 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Tongue blistering, Tongue discomfort
SMQs:, Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unable to raise arm above shoulder next day lasted a day. Blister/burn under tongue on right side of mouth


VAERS ID: 1525818 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Diarrhoea, Pyrexia, Retching, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Liothyronine 5mcgs once daily Levothyroxine 25mcgs once daily Buspirone 5mg (twice daily) Vitamin C Zinc
Current Illness: Common Cold
Preexisting Conditions: Down Syndrome
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, chills, vomiting, dry heaving, diarrhea, loss of appetite


VAERS ID: 1525821 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-08-02
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sertraline
Diagnostic Lab Data: Coronavirus 2 PCR Detect, V symptomatic POSITIVE
CDC Split Type:

Write-up: Patient exposed, reports symptoms starting on 8/2/2021, tested and found to be positive


VAERS ID: 1525828 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-06
Onset:2021-08-02
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: Coronavirus 2 PCR Detect, V asymptomatic POSITIVE
CDC Split Type:

Write-up: Exposure


VAERS ID: 1525829 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

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

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

Write-up: Migraine morning after shot accompanied by dizziness (view spinning).


VAERS ID: 1525832 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-28
Onset:2021-08-02
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / 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: Proventyl HFA 108 mcg/act inhaler as of 7/13/2021, Vitamin D 50 mcg bid, hydrochlorothiazide 25 mg, levothyroxine 25 mcg, meloxican 15 mg daily, Claritin 10 mg daily
Current Illness:
Preexisting Conditions: HTN, mitral valve prolapse, hypothyroidism, arthritis, BMi 47.38 kg/mxm, history of pneumonia
Allergies: Beta adrenergic blockers, Augmentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Contracted Covid after being fully vaccinated.


VAERS ID: 1525845 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-30
Onset:2021-08-02
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/3/21 COVID-19/SARS-COV2, PCR POSITIVE
CDC Split Type:

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


VAERS ID: 1525848 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Cough, Ear infection, Electrocardiogram normal, Headache, Illness, Nasal congestion, Pyrexia, SARS-CoV-2 test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler as needed
Current Illness: Seasonal allergies
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: Covid test on August 2, got the negative result on August 3rd. Chest xray and ECG on July 30th with nothing remarkable on those tests.
CDC Split Type:

Write-up: Patient had chest pain 3 days after 2nd vaccine, took to E.R. He had a low grade fever, and they did chest xray and ECG and those tests came back fine, he was given Decadron steroid dose at the E.R. At day 6 his chest was hurting again from coughing very badly, having nasal congestion, headache, and vomiting. I took him back to the E.R. and found out he has a severe left ear infection. The E.R. department tested him for Covid which came back negative. They said the ear infection and viral things could be a response from his immune system from the vaccine. Patient is the only person in our house that is sick. We are at day 9 after the vaccine and he is still sick, still coughing very badly and he is taking Amoxicillin for the ear infection, Robitussin for the cough, and his Albuterol inhaler. We are following up with his regular doctor today to see if there is anything else or something different they can give him to help with all of the coughing.


VAERS ID: 1525854 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Crying, Loss of consciousness, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Patient has fainted before but never this Long
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed out in the chair immediately following vaccine. After she would not wake up a few minutes later 911 was called. She still did not wake up once 911 was here. After they did a sternum run she woke, was crying historically, and unresponsive to their questions. She was put on the stretcher and went to the hospital


VAERS ID: 1525869 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-03
Onset:2021-08-02
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coronavirus 2 PCR Detect, V asymptomatic POSITIVE
CDC Split Type:

Write-up: Exposed, no symptoms listed


VAERS ID: 1525870 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood creatine phosphokinase normal, Chest X-ray normal, Chest pain, Computerised tomogram head normal, Drug screen positive, Electroencephalogram normal, Full blood count normal, Hypoaesthesia, Metabolic function test normal, Petit mal epilepsy, Pregnancy test urine negative, Seizure, Staring, Troponin normal, Urine analysis normal
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Drug abuse and dependence (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: HPV, other details unknown
Other Medications: keppra
Current Illness: none known
Preexisting Conditions: epilepsy and non-epileptic seizures
Allergies: none
Diagnostic Lab Data: Normal head CT w/o contrast 8/3/21, normal CXR 8/2/21, EEG 8/3/21, normal CBC/CMP/CPK/Troponin/UPT/UA all normal 8/2/21, drug screen 8/2/21 revealed benzodiapepines only but this was after she was given midazolam.
CDC Split Type:

Write-up: 20min after 1st Moderna injection, patient was reported to have a "blank stare" by the person sitting next to her, felt like she was about to have a seizure. She c/o chest pain and numbness, then numbness of the face. She did have several seizures in a row-at first they were shorter duration involving the eyes and arms and then grew to longer duration and full body extension. She was sent to the ED via ambulance and admitted to the hospital.


VAERS ID: 1525897 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Hyperaesthesia, Pain in extremity
SMQs:, 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: generic allergy medicine, birth control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: My symptoms started at 5pm after the first dose at 10am. I was extremely tired and could fall asleep anywhere. My right arm was sore and sensitive to the touch.


VAERS ID: 1525907 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

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

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

Write-up: Hives to full body started two hours post vaccine continued at 72 hours still continuing no sob no cp no other symptoms


VAERS ID: 1525930 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-24
Onset:2021-08-02
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Pleuritic pain, Productive cough, SARS-CoV-2 test positive, Sputum purulent
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: acetaminophen (TYLENOL) 500 mg oral tablet acyclovir (ZOVIRAX) 400 mg oral tablet aspirin 81 mg oral enteric coated tablet cholecalciferol, vitamin D3,, 5000 units=125 mcg, 5,000 unit (125 mcg) oral tablet dexAMET
Current Illness:
Preexisting Conditions: Cardiomyopathy, unspecified type (HCC) Hypothyroidism due to Hashimoto''s thyroiditis Multiple myeloma not having achieved remission (HCC) Essential hypertension
Allergies: Caffeine Quinine
Diagnostic Lab Data: Ref Range & Units SARS-CoV-2 by PCR Negative for SARS-CoV-2 RNA by PCR: Positive for SARS-CoV-2 RNA by PCR: Abnormal E Gene Ct cycles 24.3 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. N2 Gene Ct cycles 26.3 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. Resulting Agency NMRL Specimen Collected: 08/02/21 23:28 Last Resulted: 08/03/21 00:32
CDC Split Type:

Write-up: Patient is a 47 y.o. male with a history of multiple myeloma not having achieved remission on chemotherapy, nonischemic cardiomyopathy EF 40-45% and hypertension who presents with worsening shortness of breath associated with productive yellow/white sputum, and pleuritic chest pain ongoing for last 2 days worse today. His heart rate in the 140s en route. Denies fevers and chills, leg swelling, hemoptysis, diarrhea, nausea/vomiting or urinary symptoms.


VAERS ID: 1525969 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-09
Onset:2021-08-02
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Papilloma viral infection, Postmenopausal haemorrhage, Smear cervix abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 40 mg Lisinopril 10 mg Nifedipine 120 mg
Current Illness: No illnesses prior to the vaccination except for high blood pressure being managed by prescription
Preexisting Conditions: See Item 10.
Allergies: none that I''m aware of
Diagnostic Lab Data: OBGYN test results. I have a scheduled colposcopy for 8/16/21. However since I am now spotting, I have an appointment on 8/11/21 for testing
CDC Split Type:

Write-up: I am post menopausal and prior to my annual Obgyn visit, I felt like I may have either worn something that caused a little irritation or I was about to have a yeast infection. A couple days later I had my annual pap screening. My results came back that I had ASC-US and HPV. I have been celibate for over 20 years and have had regular annual screenings and was never told I had HPV even when I was sexually active. A few days after my exam I began spotting. I was advised that there have been an increase in post menopausal women experiencing spotting after taking the vaccine.


VAERS ID: 1526037 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-03-12
Onset:2021-08-02
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNK / 1 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Diarrhoea, Fatigue, Myalgia, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), 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: NONE.
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: SARS-COV19 Intranasal swab + PCR; positive 3 AUG 2021.
CDC Split Type:

Write-up: SARS-COV 19 Infection. Cough, congestion, runny nose, Diarrhea, Loss of taste, loss of smell, sore throat, fatigue, chills, muscle aches.


VAERS ID: 1526038 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Within a minute of administering the vaccine. The patient fainted. She was conscious within a minute of fainting but was visibly confused. Her vital signs were normal and was able to speak and answer questions about her breathing and pain. EMT was on site within 5-10 mins of the incident and took her to the emergency room. She is currently home resting.


VAERS ID: 1526072 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-20
Onset:2021-08-02
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Immediate post-injection reaction, Injection site pain, Injection site pruritus, Injection site rash, Injection site reaction, Injection site swelling, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: Very bad allergic reaction (but not life threatening) - swelling, itching, pus and eventual shedding of skin all over body (head
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Hydrocortisone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Currently pregnant at 27 weeks, 3 days - estimated due date October 31. Adverse event happened about 2 weeks after the first dose: Redness, slight swelling, tenderness and itching around and surrounding injection site. The patch is irregular in shape and relatively large (about 6 inches long, 3-4 inches wide). Looks like "Covid Arm". Started itching a couple days ago (thought it was a mosquito bite) and eventually spread over the next day. There were no other adverse effects aside from a sore arm immediately after the shot was given.


VAERS ID: 1526075 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

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

Write-up: Headache, chills, fever, cough, runny nose, fatigue


VAERS ID: 1526142 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Appendicectomy, Appendicitis, Back pain, Computerised tomogram abdomen abnormal, Diarrhoea, Nausea, Scan with contrast abnormal, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: Meningitis; age 22; swelling of vaccine site
Other Medications: Birth control, Blood pressure medicine, Anxiety medicine, Vitamin D & C
Current Illness:
Preexisting Conditions:
Allergies: Sulpha drugs, Levoquin
Diagnostic Lab Data: CT scan with contrast (8-3-21) Urinalysis (8-3-21)
CDC Split Type:

Write-up: Acute Appendicitis that led to an appendectomy. Symptoms: severe abdominal and back pain, nausea and vomiting, diarrhea (8-2-21, starting at about 7:00 PM)


VAERS ID: 1526165 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Eye swelling, Feeling abnormal, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient''s mom reported that pt had a temp of 104 after the vaccine and then on Monday she had swollen eyes. She had a swollen arm and is still feeling miserable. Patient''s mom gave her Benadryl.


VAERS ID: 1526180 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: The night patient received vaccine she had multiple dime-sized bruises on both arms. She was advised to go to the doctor if bruising got worse. Checked in with patient 08/04/2021 and she reported that bruising has improved.


VAERS ID: 1526189 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 RA / IM

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

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

Write-up: I was with a new nurse training in OB when the clerks paged for a COVID vaccine waiting for nurse. I finished helping the nurse 15 minutes later and noticed the COVID vaccine papers were still waiting for a nurse. The next maternity patient was ready but I sent the new nurse to get vitals and UA while I grabbed the COVID and would come back to the nurse since the other nurses were still busy. It ended up being 3 COVIDS together and not 1. I had to explain to the parents that the child could not get the J&J like they were told they could get because of her age and that she could only get Pfizer. The parents were not happy but I quickly went to draw up all the vaccine since I had a scheduled patient waiting. Reconciliation was done Friday afternoon when I was off work so I mixed up the vaccine and gave it to them making sure I gave the child the correct thing and sent them to the waiting room to wait their time and get the lottery tickets that the parents wanted. I realized after I gave the vaccine that the vial was expired and did not think about it at the time it was drawn up because the month had just changed over the weekend and I was not at work the week before to realize it was expiring soon and reconciliation had just been done and the vaccine was still in the stock fridge and not labeled expired. Dr. discusses incident with Pfizer and was told that dose is valid but report still needed to be completed.


VAERS ID: 1526231 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-11
Onset:2021-08-02
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Infection, Suspected 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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Suspected covid breakthrough


VAERS ID: 1526306 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated
SMQs:

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

Write-up: The evening of the vaccine, I had a heightened reaction to celery. While I do have an oral allergy to celery if eaten directly, I have never had an issue with it blended into smoothies, cooked, etc. I drink a smoothie almost daily with celery without any issue. Around 730pm, I drank my smoothie and within 10 minutes, my throat and chest tightened significantly, similar to my rxn to nuts. I took a zyrtec and it resolved after an hr.


VAERS ID: 1526313 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / IM

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

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

Write-up: after receiving the vaccine, the patient was leaving the store and fainted. He was helped to a sitting position by store staff and given water and crackers. He left after approximately 15 minutes.


VAERS ID: 1526339 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / ID

Administered by: Other       Purchased by: ?
Symptoms: Incorrect route of product administration, Injection site cellulitis, Product administered at inappropriate site, Underdose
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

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

Write-up: Patient was inadvertently given 0.1ml of Janssen Covid 19 vaccine intradermally left lower forearm. 2 days later patient has cellulitis symptoms at area of injection, and reports worsening daily. Treated with antibiotic course, started today, Keflex 500mg PO 4x daily x 10 days. No other systemic issues, only localized.


VAERS ID: 1526342 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling cold, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Extreme dizziness, nausea, committing followed by cold chills.


VAERS ID: 1526345 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

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

Write-up: Patient reported itch the night of the immunization which was relieved by Benadryl but reported anaphylaxis about 24 hours after immunization


VAERS ID: 1526357 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-08-02
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise
SMQs:

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: pt admitted to the hospital for COVID 19 symptoms post vaccination.


VAERS ID: 1526518 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER / 1 RA / IM

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

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

Write-up: Patient mentioned she was afraid of needles and also mentioned she''s fainted from getting blood drawn. Technician told her to relax and then gave her the vaccine. Pt stated she was feeling dizzy, technician told her to sit and rest. Pt fell off her chair & blacked out


VAERS ID: 1526751 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-26
Onset:2021-08-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Pain in extremity, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient developed a red rash on 8/2, 7 days after receiving her first Moderna vaccine. She said that her arm was sore a couple of days after she got the vaccine, then it became itchy (and she says she scratched at the injection site), and then on 8/2, it became red, warm to the touch, and tender.


Result pages: prev   194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=293&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166