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

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



Case Details (Reverse Sorted by Onset Date)

This is page 294 out of 7,116

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VAERS ID: 1526772 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-09
Onset:2021-08-02
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (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: Synthroid
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Tinnitus.


VAERS ID: 1526928 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
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 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oropharyngeal pain, Pain, Skin discolouration
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypotonic-hyporesponsive episode (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: Ativan Zyrtec Pro Air
Current Illness: Asthma
Preexisting Conditions: Mast Cell Activation Disorder Asthma Ehlers Danlos Syndrome Chiari Malformation TIA hx Basilar Migraine Raynauds Syndrome Fibromyalgia Fatty Liver Hemi facial spasm Thyroid nodule
Allergies: Penicillin Tetracyclin Cipro/Levaquin Iodine Bactrim Macrobid Azythromyacin Prednisone NSAIDS Pepcid Benadryl Lidocaine Latex Lactose Intolerant
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore throat 4 plus days Body aches White cirle on left arm with shiny look


VAERS ID: 1527164 (history)  
Form: Version 2.0  
Age: 29.0  
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 (MODERNA)) / MODERNA - / 7+ LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Electrocardiogram, Erythema, Eye movement disorder, Gait disturbance, Headache, Hyperhidrosis, Lip discolouration, Malaise, Seizure, Staring
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: My daughter and I went for her to get the Covid Vaccine and was given Moderma. I was about to walk away when she called me back and said she didn''t feel well. I was trying to ask was she ok but she just had a blank stare and then her eyes went back and she started to convulse. That lasted about 10-15 seconds. When she came through she was disoriented and she had red circles under her eyes and her lips were discolored also she started to sweat profusely and had an intense headache. I was calling for help from the pharmacy staff but I couldn''t get them to respond, until another gentleman that was there also for the vaccine started shouting for then to help. Someone finally came and asked would we like for her to call 911, to which I asked her to please. I was going to take her to the ER, but she said she couldn''t walk. The EMS got there about 30 minutes later and did and EKG and some other check. At that time they advised my daughter against going to a hospital because of long wait times and the high amount of Covid cases, so she declined. They also advised her to see a neurologist. At that time I took her home and have been monitoring her.


VAERS ID: 1527317 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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: Omeprozal
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever and tingling/burning sensation in hands and feet. Fever is lasted roughly 48hrs but the tingling/burning sensation is still present as of 08/05.


VAERS ID: 1527851 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-25
Onset:2021-08-02
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER 8732 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Fatigue, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Tested positive for COVID on 8/3/2021
CDC Split Type:

Write-up: Symptoms of sore throat, fatigue, nasal congestion started on 08/02/21. Tested positive for COVID on 8/3/2021


VAERS ID: 1527859 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-02-20
Onset:2021-08-02
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Fatigue, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Tested positive for COVID on 8/3/2021.
CDC Split Type:

Write-up: Patient developed cough, fatigue, muscle aches, sore throat, chills and subjective fevers on 8/2/2021. He tested positive for COVID on 8/3/2021.


VAERS ID: 1528159 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions: Comments: the patient was healthy and had not been sick for least 15 plus years.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210805033

Write-up: EVERY SYMPTOM KNOWN TO MAN (EXCEPT FOR FULL BODY RASH); This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient was healthy and had not been sick for least 15 plus years. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 02-AUG-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch number. No concomitant medications were reported. On 02-AUG-2021, the subject experienced every symptom known to man (except for full body rash). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of every symptom known to man (except for full body rash) was not reported. This report was non-serious.


VAERS ID: 1528161 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Chills, Cough, Dyspnoea, Headache, Heart rate, Heart rate irregular, Malaise, Nausea, Painful respiration, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (once a week)
Preexisting Conditions: Medical History/Concurrent Conditions: Smoker (Quit on September 2020); Comments: The patient had no known drug allergies. The patient did not have any history of drug abuse or illicit drug use. The patient had no past medical history of cardiac problems.
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Heart rate; Result Unstructured Data: 3/4ths pause between afib and defib
CDC Split Type: USJNJFOC20210805060

Write-up: BIG PAUSE BETWEEN HEARTBEATS (HEAR RATE WITH A 3/4THS PAUSE BETWEEN AFIB (ATRIAL FIBRILLATION) AND DEFIB DE-FIBRILLATION)); SHORTNESS OF BREATH; HURTS TO BREATHE; PAIN IN THE AORTA; VOMITING; COLD WITH SHAKING; FEELING UNWELL; 10 SEVERE HEADACHE (8 OUT OF 10, WITH BEING WORST); NAUSEA; COUGHING; This spontaneous report received from a patient concerned a 24 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included smoker, and concurrent conditions included alcohol user, and other pre-existing medical conditions included the patient had no known drug allergies. the patient did not have any history of drug abuse or illicit drug use. the patient had no past medical history of cardiac problems. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 02-AUG-2021 17:11 for prophylactic vaccination. No concomitant medications were reported. On 02-AUG-2021, the subject experienced coughing. On 02-AUG-2021, the subject experienced nausea. On 03-AUG-2021, the subject experienced big pause between heartbeats (hear rate with a 3/4ths pause between afib (atrial fibrillation) and defib de-fibrillation) ). On 03-AUG-2021, the subject experienced shortness of breath. On 03-AUG-2021, the subject experienced hurts to breathe. On 03-AUG-2021, the subject experienced pain in the aorta. On 03-AUG-2021, the subject experienced vomiting. On 03-AUG-2021, the subject experienced cold with shaking. On 03-AUG-2021, the subject experienced feeling unwell. On 03-AUG-2021, the subject experienced 10 severe headache (8 out of 10, with being worst). Laboratory data included: Heart rate (NR: not provided) 3/4ths pause between afib and defib. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from cold with shaking, and had not recovered from coughing, big pause between heartbeats (hear rate with a 3/4ths pause between afib (atrial fibrillation) and defib de-fibrillation)), 10 severe headache (8 out of 10, with being worst), vomiting, pain in the aorta, shortness of breath, hurts to breathe, nausea, and feeling unwell. This report was non-serious.


VAERS ID: 1528166 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 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: USJNJFOC20210805234

Write-up: INCORRECT PRODUCT STORAGE; VACCINE ADMINISTERED WHICH HAD PAST 87 HOURS STABILITY; This spontaneous report received from a consumer concerned a 56 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 201A21A expiry: 07-AUG-2021) dose was not reported, administered on 02-AUG-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 02-AUG-2021, the subject experienced vaccine administered which had past 87 hours stability. On an unspecified date, 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 which had past 87 hours stability and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1528397 (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: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Hypotension, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), 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), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild


VAERS ID: 1528548 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-08
Onset:2021-08-02
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Positive for Covid 19


VAERS ID: 1528574 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-05
Onset:2021-08-02
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / 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: Fully vaccinated individual admitted for COVID symptoms.


VAERS ID: 1528641 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Body temperature increased, Diarrhoea, Headache, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (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? 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: My temp was up to 102.9 blood pressure spiked to 140/110 pulse was 160 and respiration?s were in the 40s. I had body aches like no other diarrhea and a headache that was excruciating.


VAERS ID: 1528647 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products, 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type: AR2051

Write-up: Patient was inadvertently administered incorrect COVID vaccine. Due to age patient should have received Pfizer COVID vaccine, Janssem vaccine was administered. Attempted to call patient several times 8/2/21 no answer or on voice mail. Called pt. today grandmother answered pt. was home, informed grandmother of incident and she stated patient was doing well and no S&S of adverse reactions.,


VAERS ID: 1528652 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-24
Onset:2021-08-02
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Headache, Respiratory tract congestion
SMQs:, Anaphylactic reaction (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: PATIENT IS HAVING CONGESTION, HEADACHE AND COUGH.


VAERS ID: 1528702 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Folliculitis, Fungal skin infection, Palpitations, Pruritus, Pyrexia, Rash, Rash maculo-papular, Sensitive skin
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 88mcg QAM 2 days per week and Synthroid 75mcg QAM 5 days per week.
Current Illness:
Preexisting Conditions: Leveling out thyroid symptoms. Was over medicated for awhile on levothyroxine and NDT thyroid for 2 years.
Allergies: Sulfa drugs cause nausea
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on chest and back. Similar to rash when likely infected with COVID -19 in January of 2021. Manifests as maculopapular rash predominantly on trunk. Exacerbates fungal skin infections (fungal folliculitis). Itching. Sensitive skin. Fever. Heart pounding.


VAERS ID: 1528722 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-31
Onset:2021-08-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Nasal congestion, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: person developed chills, cough, sore throat, stuffy nose on monday night (8/2/21) after receiving dose 1 of the Moderna covid vaccine on sunday 7/31/21. She called the pharmacy on 8/5/21 to report this to us. The symptoms were still happening, but to a lesser degree than the previous days. She did not have any soreness in the injected arm. She took ibuprofen and nyquill for the symptoms, which helped.


VAERS ID: 1528742 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-08-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Hives x 4 days


VAERS ID: 1528757 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, B, D
Current Illness: Cold/Bronchitis/Asthma
Preexisting Conditions: none
Allergies: Cipro Flagyl
Diagnostic Lab Data:
CDC Split Type:

Write-up: The morning after the vaccine, I woke up with dizzy spells and have had on and off every day since day of 1st vaccination


VAERS ID: 1528871 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Oropharyngeal pain, Pharyngeal paraesthesia, Pharyngeal swelling, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: eggs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Face and throat swelling, sore/tingling throat, skin redness (mostly face, neck and chest). Took 2 Benadryl, face/throat swelling and redness subsided within 8 hours.


VAERS ID: 1528891 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-31
Onset:2021-08-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, C-reactive protein increased, Cardiac imaging procedure abnormal, Chest pain, Ejection fraction decreased, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Magnetic resonance imaging heart, Myocarditis, Myoglobin blood increased, SARS-CoV-2 test negative, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (narrow), Cardiac failure (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin Ibuprofen on the morning of 8/3
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 8/4: Cardiac MRI - late gadolinium enhanced images demonstrate focal subepicardial linear enhancement of the myocardium and pericardium in the later and inferolateral segments. Troponin: 8/3 19:00: 11.04 ng/mL 8/3 20:30: 17.36 ng/mL 8/4 05:17: 17.94 ng/mL 8/4 11:55: 13.72 ng/mL 8/4 22:00: 12.44 ng/mL BNP 8/3 21:35: 107 pg/mL Myoglobin 8/3 20:30: 745 ng/mL CRP High Sensitivity 8/5 06:10: 50.50 mg/L SAR COV2 IgG: negative SARS COV2 PCR: Not detected Influenza A PCR: Not detected Influenza B PCR: Not detected
CDC Split Type:

Write-up: Myopericarditis confirmed by cardiac MRI and reduced ejection fraction to 50%. Patient presented to the hospital with chest pain and troponin''s were elevated up to 17.94 ng/mL. Patient remained hemodynamically stable and chest pain resolved with 650 mg of acetaminophen. Patient was initiated on captopril 6.25 three times daily while hospitalized and transitioned to lisinopril 2.5 mg upon discharge.


VAERS ID: 1528900 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Blepharospasm, Cardiac flutter, Chest discomfort, Confusional state, Diarrhoea, Dyspepsia, Extrasystoles, Eye disorder, Fatigue, Feeling abnormal, Gingival pain, Hypoaesthesia, Lacrimation increased, Memory impairment, Pain in extremity, Periorbital swelling, Swelling face, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Retinal disorders (broad), Tachyarrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (broad), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: In 2005 or 2006, I received a Smallpox vaccine and a few hours later completely blacked out and fainted. I have also had migrain
Other Medications: Taking multi vitamin, iron, B vit, magnesium, Vit C, Seasonique birth control pills
Current Illness: None
Preexisting Conditions: Hypoglycemia and anemia/low iron
Allergies: pennicilen, amoxicillen, azithromycin
Diagnostic Lab Data: I have a doctor''s appointment today and will see if there are tests we can do to figure all this out.
CDC Split Type:

Write-up: Started off pretty typical with ongoing diarrhea that lasted 2 days until I took Pepto Bismol to slow it down, fatigued, sore arm and then the 2nd day I had a heavy feeling in my cvhest and felt almost like a scratchy/sore throat. I had my heart flutter and skip beats a few times and on the 2nd day also had heartburn which I never get. On the 3rd day, I felt better and mostly fine aside from really tired. From days 4-6 this is what has been happening- Day 4 I started to feel confused and extremely forgetful. I couldn''t get my car to start and was worried because I needed to pick my son up. I had forgotten my keys. I put utensils I had just washed into the dish scrub container rather than the dish rain and utensil holder attached to it. I couldn''t remember which vitamins from my daily vitamin holder I took and got confused about the days. The list of "brain fog" goes on but these other things concern me a lot too. On day 4 my eyelid also started twitching non stop all day long. This was my left eye kid and not normal for me. I had weird random pains in my gumline too from under my nose which is new. Then that night, my left leg went numb. I am solo parent to a medically fragile child so I couldn''t drag him out of bed in the middle of the night to rush to the ER. I woke the next morning with feeling back in my leg Thank God. On day 5, I noticed my eyes are no longer in alignment. They keep wandering outward. This is not normal for me. I have never had eye issues. Today is day 6 and every day I wake up my face is puffy and I have big bags under my eyes. My eyes now keep watering, specifically my left eye. They are still not aligned properly. I am terrified of what the next days are going to bring. My little boy needs me.


VAERS ID: 1528996 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Inappropriate schedule of product administration
SMQs:, Dementia (broad), Medication errors (narrow)

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

Write-up: SHE GOT HER FIRST COVID SHOT ON 7/19/21 AND I DID NOT REALIZE THAT. WHEN SHE GOT HER 2ND SHOT FROM ME IT WAS ON DAY 14. I TALKED TO PATIENT AND SHE SAID THE SHOT MADE HER FEEL POORLY FOR A DAY JUST LIKE THE FIRST VACCINE.


VAERS ID: 1529030 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Back pain, Chills, Fatigue, Headache, Nausea, Neck pain, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Took an ibuprofen 30 minutes before vaccine. Took Tylenol every 6 hours prn when adverse effects started.
Current Illness: No other illnesses.
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: About 5 hours after the administration of the Pfizer vaccine I started to experience a mild headache. About 9pm I started getting body aches, fever, chills, joint pain, fatigue, weakness, and nausea,. The back of my neck and back hurt the worst. I also experienced leg pain and my feet hurt pretty bad. I could not move without hurting. The fever lasted all night off and on. The next day the fever continued but it was low grade. The body/muscle aches continued but not as bad as the day before. The fatigue was worse during the second day. On the 3rd day after the vaccine I felt almost normal.


VAERS ID: 1529067 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-06
Onset:2021-08-02
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / IM

Administered by: Private       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: As of 7/6/2021 10:50 AM azithromycin 250 MG Take 2 tablets (500 mg) on Day 1, followed by 1 tablet (250 mg) once daily on Days 2 through 5. cyanocobalamin (vitamin B-12) 1,000 mcg Intramuscular Once ergocalciferol (vitamin D2) 50,000 u
Current Illness: None
Preexisting Conditions: Hypothyroidism Other Menorrhagia Fibroids, intramural Chronic blood loss anemia History of robot-assisted laparoscopic hysterectomy
Allergies: Latex LatexHivesMediumAllergy4/9/2018Deletion Reason: Banana BananaNot Specified11/28/2020Deletion Reason: Kiwi (Actinidia Chinensis) Kiwi (Actinidia Chinensis)Not Specified12/17/2020Deletion Reason: Latex LatexNot Specified1/31/2018Deletion Reason: Pineapple Pineapple
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vaccine prepped on 7/2/2021 and administered on 7/6/2021. Pt reported no s/s. Moderna notified of error and recommendation given not to revaccinate.


VAERS ID: 1529083 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye contusion, Fall, Fatigue, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Microgestin birth control, had taken the morning of vaccine date
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood Pressure: 110/60
CDC Split Type:

Write-up: About 10 minutes after the vaccination, the patient fainted in the pharmacy and hit the side of her head. She came to immediately upon prompting by pharmacy staff. I administered 25mg diphenhydramine and gave her a bottle of water. We left her supine for 10 minutes, and then sat her in a chair and checked her blood pressure and it was 110/60. She never stopped breathing or lost a pulse. Patient stated that she had been dieting and hadn''t eaten at all that day yet. I obtained permission to call her parent and she came to the pharmacy immediately. We monitored her for an additional 30 min in the pharmacy and she had no breathing difficulties, no rash, no itching, and said she felt fine. So after the 30 minute waiting period, we let her Mother drive her home. I followed up several times that evening and daily for 2 additional days. Other than a black eye from falling, and needing a day post-vaccine to rest from fatigue, she felt fine today.


VAERS ID: 1529122 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Epistaxis, Pyrexia, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Vaginal Bleeding, nose bleeds, high fever


VAERS ID: 1529151 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac function test normal, Chest X-ray normal, Chest pain, Computerised tomogram thorax, Condition aggravated, Dizziness, Dyspnoea, Dyspnoea exertional, Echocardiogram normal, Electrocardiogram, Fibrin D dimer increased, Hypoaesthesia, Metabolic function test normal, Muscular weakness, Throat tightness, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Otherwise healthy
Preexisting Conditions: Otherwise Healthy
Allergies: Sulfa Drugs: causes vomiting
Diagnostic Lab Data: Patient is a 17yo otherwise healthy M presenting with new onset CP and SOB. He reports getting his 2nd covid vaccine earlier today (8/2/21) at 11am. He felt well afterwards and then ran 3 miles in cross country followed by marching band practice where he began to experience gradual onset of central, non-radiating chest pain. Describes it as achy, 3/10, lasting ~1 hour before spontaneously resolving. However he then went on to develop SOB during exertion. Says he has had similar CP in the past while running but the SOB is new for him. Describes it as feeling like he can''t get enough air in associated with a tightness sensation in his throat. Along with the SOB he noticed lightheadedness and weakness when standing up from sitting as well as L hand numbness. SOB lasted several hours but has since improved significantly. Denies nausea, vomiting, diaphoresis, LE pain or swelling, syncope, palpitations. No recent illness, URI sxs, fevers, or myalgias. No history of asthma or other lung issues, cardiac issues, or bleeding/clotting disorders. Patient initially presented to hospital where he was found to have elevated troponin to 0.26 and D-dimer to 748. EKG x2 with some concern for s1q3t3 but otherwise reassuring. CTA was obtained which was negative for PE. CXR and BMP unremarkable. He did receive ASA and albuterol and symptoms have since resolved. Transferred to another hospital for further workup. While at hospital, repeat troponins were obtained and were decreasing while admitted: 8/3/21 @0329: 413 ng/L 8/3/21 @1000: 212 ng/L 8/3/21 @1613: 128 ng/L Patient received a single dose of APAP 650 mg and Ibuprofen 600 mg while inpatient. Patient is 90 kg. ECHO performed inpatient showed normal cardiac function. Patient has f/u with cardiology in one month for repeat EKG and ECHO. Cardiology recommended avoiding exercise and physical exertion until appointment. Cleared to use aspirin and ibuprofen for pain. Anticoagulation was deferred.
CDC Split Type:

Write-up: Patient is a 17yo otherwise healthy M presenting with new onset CP and SOB. He reports getting his 2nd covid vaccine earlier today (8/2/21) at 11am. He felt well afterwards and then ran 3 miles in cross country followed by marching band practice where he began to experience gradual onset of central, non-radiating chest pain. Describes it as achy, 3/10, lasting ~1 hour before spontaneously resolving. However he then went on to develop SOB during exertion. Says he has had similar CP in the past while running but the SOB is new for him. Describes it as feeling like he can''t get enough air in associated with a tightness sensation in his throat. Along with the SOB he noticed lightheadedness and weakness when standing up from sitting as well as L hand numbness. SOB lasted several hours but has since improved significantly. Denies nausea, vomiting, diaphoresis, LE pain or swelling, syncope, palpitations. No recent illness, URI sxs, fevers, or myalgias. No history of asthma or other lung issues, cardiac issues, or bleeding/clotting disorders. Patient initially presented to hospital where he was found to have elevated troponin to 0.26 and D-dimer to 748. EKG x2 with some concern for s1q3t3 but otherwise reassuring. CTA was obtained which was negative for PE. CXR and BMP unremarkable. He did receive ASA and albuterol and symptoms have since resolved. Transferred to another hospital for further workup. While at hospital, repeat troponins were obtained and were decreasing while admitted: 8/3/21 @0329: 413 ng/L 8/3/21 @1000: 212 ng/L 8/3/21 @1613: 128 ng/L Patient received a single dose of APAP 650 mg and Ibuprofen 600 mg while inpatient. Patient is 90 kg. ECHO performed inpatient showed normal cardiac function. Patient has f/u with cardiology in one month for repeat EKG and ECHO. Cardiology recommended avoiding exercise and physical exertion until appointment. Cleared to use aspirin and ibuprofen for pain. Anticoagulation was deferred.


VAERS ID: 1529167 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-12
Onset:2021-08-02
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN-NOT IN / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN-NOT IN / 2 LA / SYR

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

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

Write-up: Received Moderna vaccines on 1/15/21, 2/12/21 Tested positive for COVID by PCR on 8/2/21 Admitted to Hospital on 8/2 and transferred to another Hospital on 8/3/21. Patient is asymptomatic for COVID and was hospitalized for acute pancreatitis.


VAERS ID: 1529168 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-08-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

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

Write-up: Patient received 2nd dose vaccine and came to the EC for shortness of breath and loud wheezing, patient has significant history for bronchial asthma (last hospitalized for bronchial asthma exacerbation 2/2020).Patient states she had been wheezing for about a week, but more noticeably in last 1 day.


VAERS ID: 1529242 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-08-02
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

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

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

Write-up: Positive for Covid 8/5/2021


VAERS ID: 1529249 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cheilitis, Erythema, Eye swelling, Joint swelling, Lip swelling, Swelling face, Swelling of eyelid, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: About 12:00 pm the day after vaccination, a small reddened area appeared on the left wrist which was about the size of a quarter along with a small dime sized raised area that looked like a hive in the middle of reddened area. Also reported inflammation of right side of upper lip. Patient describes that it looks as if he had botox injections. Swelling in lip and hive on wrist has slowly improved. On 8/5/21 states he awoke with a swollen eye on his left side. Says that it was so swollen in the morning that his eye was closed shut. Says that today he also noticed that although the lip swelling has improved, he has some swelling in his left cheek in close proximity to his lip.


VAERS ID: 1529260 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-08-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MVT, probiotic, vit D
Current Illness: none
Preexisting Conditions: chronic migraine; recurrent epistaxis
Allergies: topamax
Diagnostic Lab Data:
CDC Split Type:

Write-up: intense pruritus bilateral axillae, with progressive rash from bilateral axillae to neck and up behind ears. axillary lymphadenopathy, headache, dizziness.


VAERS ID: 1529348 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Back pain, Blood test normal, Dysarthria, Electrocardiogram normal, Facial paralysis, Gait disturbance, Injection site pain, Lethargy, Muscle spasms, Myalgia, Oedema peripheral, Palpitations, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/4/21- EKG- normal Complete blood work- normal
CDC Split Type:

Write-up: 8/1/21: injection- normal pain, with muscle soreness all over. 8/2/21: woke with intense pain in all joints, muscles spasms in back and legs. Difficulty speaking and using lips to produce words. Feeling of mild paralysis all over body difficulty walking. Sharp moving pains under her left arm and down the left side of body predominately in the lower back up to the shoulder blade of the left side of the body. 8/3/21: Sharp pains continued under her left arm and swelling under left arm pit. Lower and upper back pains. Lethargic and difficulty speaking, remainder of the day. 8/4/21: Left arm-tingling. Racing heart rate causing slurred speech and difficulty speaking. Taken to the ER and ran an EKG and blood work nothing abnormal found. Set home to rest because of overcrowded ER area with Covid patients. Told to rest and breathe to prevent slurred speaking. 8/5/21: speaking is normal. Less lethargic. Back pain has lessened.


VAERS ID: 1529400 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Decreased appetite, Electric shock sensation, Feeding disorder, Headache, Hyperhidrosis, Lymphadenopathy, Nausea, Pain, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies: None known
Diagnostic Lab Data: Have not seen a doctor yet.
CDC Split Type:

Write-up: Severe body aches and pains and headache. Nausea, fever of 102 for 23 hours first day followed by heavy sweats the second. No appetite and unable to eat. Could drink water. Second day developed enlarged supraclavicular lymph nodes in my neck and is still swollen into third day. The lymph nodes cause a weird "electric" feeling. Aching in joints and especially in hips. Itching on extremeties since first day.


VAERS ID: 1529407 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-08-02
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: positive covid19 PCR test 8/4/21
CDC Split Type:

Write-up: fully vaccinated (Pfizer, 4/22/21, 5/13/21), onset of symptoms 8/2/21


VAERS ID: 1529409 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-01-13
Onset:2021-08-02
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 LA / IM

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

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

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


VAERS ID: 1529412 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-23
Onset:2021-08-02
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: positive covid19 PCR test 8/4/21
CDC Split Type:

Write-up: fully vaccinated (Pfizer, 4/2/21, 4/23/21); onset of symptoms on 8/2/21


VAERS ID: 1529423 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3 - 4000 IU B-Complex - 1 capsule Evening Primrose Oil - 1000 mg Borage Oil - 1000 mg DHA - 300 mg EPA - 150 mg Turmeric - 1,350 mg (with Black Pepper - 9 mg) Cinnamon - 450 mg NAC - 600 mg
Current Illness:
Preexisting Conditions:
Allergies: nuts, sesame, mustard
Diagnostic Lab Data:
CDC Split Type:

Write-up: vertigo for 3 days


VAERS ID: 1529744 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: None
Preexisting Conditions: has Dermatographic Urtcaria and takes Zyrtec daily and as needed for hives.
Allergies: Cefzil
Diagnostic Lab Data:
CDC Split Type:

Write-up: complained that both of her feet were numb to her ankles. She said that she could not feel when she touched her feet. She also stated it felt like she could not feel the floor when she walked. She said their was no tingling sensation. I looked at both feet and they were natural color, warm to touch and she had strong pulses in both feet. No weekness in either foot or leg. This sensation lasted until Thursday morning.


VAERS ID: 1530335 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Dizziness, Dyspnoea, Fatigue, Headache, Hyperhidrosis, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levetiracetam, famotidine, birth control pill (generic)
Current Illness: No.
Preexisting Conditions: Asthma and epilepsy.
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Started with temperature of 100.4 degrees Fahrenheit at around 0200 on 02Aug21 accompanied by chills, excessive sweating, nausea, lightheadedness, and a headache. Extreme exhaustion set in as well around the same time with my temperature increasing to 101.2 after an hour (0300). The same symptoms continued until 1000 on 02Aug21 when my temperature reached 101.8 degrees. Around 1600 on 02Aug21, I was having a very hard time breathing while sitting down. I also felt very dizzy when not in motion, more chills and excessive sweating, a very intense headache, and a temperature of 102.7 degrees. I slept through the night and my fever had gone down to 100.2 degrees by 0700 on 03Aug21. I developed a dry cough that would often leave me out of breath (similar to bronchitis in asthmatic people). I also had a lingering headache until roughly 1400 on 03Aug21 and no longer had a fever. Lingering cough remains on 06Aug21 with no other symptoms. Throughout the few days of having symptoms, I only took over the counter ibuprofen to help with my headache and my Albuteral inhaler to help with breathing.


VAERS ID: 1530471 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Head discomfort, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: USJNJFOC20210805246

Write-up: HEAD SEEMS LIKE IT WANTS TO EXPLODE; FEVER; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. 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: Unk) dose was not reported, administered on 01-AUG-2021 for prophylactic vaccination. The batch number was not reported. the company was unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 02-AUG-2021, the subject experienced head seems like it wants to explode. On 02-AUG-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever and head seems like it wants to explode was not reported. This report was non-serious.


VAERS ID: 1530480 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Body temperature, Feeling hot, Flushing, Oropharyngeal pain, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Whiskey once in while. Haven''t had a drink in 2 years.); Allergy to animal dander; Hypertension; Smoker (1 pack (20 cigarettes) a day.)
Preexisting Conditions: Medical History/Concurrent Conditions: Abnormal stools; Appendectomy; Injury; Neuropathy peripheral; Shoulder operation (3 years ago and 4 days before pandemic started.); Spinal operation; Tonsillectomy; Comments: The patient did not have any history of drug abuse or illicit drug use. The patient allergic to mouse feces.
Allergies:
Diagnostic Lab Data: Test Date: 20210802; Test Name: Body temperature; Result Unstructured Data: 98.9 F; Test Date: 20210802; Test Name: Body temperature; Result Unstructured Data: 100.8 F; Test Date: 20210802; Test Name: Blood pressure; Result Unstructured Data: Normal; Test Date: 20210803; Test Name: Blood pressure; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210807495

Write-up: SORE THROAT; HANDS WARM TO TOUCH; FEVER; LOOKING FLUSHED; HANDS FELT HOT; This spontaneous report received from a patient concerned a 64 year old male. The patient''s weight was 220 pounds, and height was not reported. The patient''s past medical history included accident bruise in spine, neuropathy of four limbs, issues bowel movements after spinal surgery, shoulder surgery on both side, appendix taken out, tonsils taken out, and spinal surgery, and concurrent conditions included dog dander allergy, alcohol user, smoker, and controlled hypertension, and other pre-existing medical conditions included the patient did not have any history of drug abuse or illicit drug use. the patient allergic to mouse feces.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 02-AUG-2021 09:15 for prophylactic vaccination. No concomitant medications were reported. On 02-AUG-2021, the subject experienced looking flushed. On 02-AUG-2021, the subject experienced hands felt hot. On 02-AUG-2021, the subject experienced hands warm to touch. On 02-AUG-2021, the subject experienced fever. Laboratory data included: Blood pressure (NR: not provided) Normal, and Body temperature (NR: not provided) 100.8 F, 98.9 F. On 03-AUG-2021, the subject experienced sore throat. Laboratory data included: Blood pressure (NR: not provided) Normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from looking flushed, hands felt hot, and hands warm to touch on 02-AUG-2021, and fever on 03-AUG-2021, and had not recovered from sore throat. This report was non-serious.


VAERS ID: 1531453 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS AMVA550A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blindness transient, Hyperhidrosis, Mobility decreased, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Within 5 minutes of pt receiving vaccines, pt noted to be diaphoretic and pale. Pt states she "lost vision" and "became sweaty/weak and couldn''t move" for a period of time less than one minute. Pt states she hadn''t ate prior to appt and that she was "nervous" prior to receiving vaccines. Pt provided with bottle of water. BP and Pulse WNL. Pt provided with cold washcloth. Pt''s sx improve after an additional 15 min of monitoring. Pt leaves ambulatory with driver. Pt went to work later that day.


VAERS ID: 1531459 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Rash, Rash papular, Rash pruritic, 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: Flomax Pristiq Atorvastatin
Current Illness: None
Preexisting Conditions: None except depression.
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Itchy, slightly raised rashes and welts beginning on inner left arm (not outer arm, which was injection site) and spreading to inner right arm and abdomen. All on left side except for rashes on inner right arm. Rashes not painful.


VAERS ID: 1531478 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-05
Onset:2021-08-02
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 023A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: occasional Motren
Current Illness: none
Preexisting Conditions: none
Allergies: no
Diagnostic Lab Data: visual diagnosis by P.A. working at clinic
CDC Split Type:

Write-up: The adverse event was a diagnosis of Shingles. I have not previously been vaccinated for Shingles. I did have chickenpox as a child.


VAERS ID: 1531497 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site pruritus, Myalgia, Pain, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Birth Control Vitamin C and Zinc
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 100 degrees, extreme chills even in high room temperatures and painstaking body aches. Itchy arm at vaccination site. Unable to sleep due to muscle aches.


VAERS ID: 1531558 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-29
Onset:2021-08-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad)

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

Write-up: Pulmonary embolism dx 1 week after 2nd shot-Symptoms started soon after 2nd shot


VAERS ID: 1531577 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-08-02
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 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: Blood Press, Losarthin HCT, Myrdetrig, Synthroid, meloxicam, Lyrica, citalopram
Current Illness: No
Preexisting Conditions: Hypertension, hypothyroidism, depression, arthritis
Allergies: No
Diagnostic Lab Data: Covid PCR test
CDC Split Type:

Write-up: 12/23/2020 Pfizer Covid vaccine 1/12/2021 Pfizer Covid vaccine 8/2/2021 tested positive for Covid with PCR test 8/13/21 potential to return to work


VAERS ID: 1531604 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-28
Onset:2021-08-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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

Write-up: she has been diagnosed with bell''s palsy. she was told that it would be temporoary.


VAERS ID: 1531698 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-08-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

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

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

Write-up: Rash/itchiness


VAERS ID: 1531716 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Full blood count, Muscular weakness, Paraesthesia, Vitamin B12
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: AS child- had to be spaced out.
Other Medications: Vit D
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC, CPK, B12
CDC Split Type:

Write-up: Tingling in hands progressing to weakness- started Mondy morning. Both arms and tingling in both feet.


VAERS ID: 1531731 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-06
Onset:2021-08-02
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac disorder, Chest pain, Vascular graft
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: Unknown.
CDC Split Type:

Write-up: Patient had chest pains for several days after receiving the Pfizer COVID-19 vaccine. He went to a local doctor who then had patient submitted to an unknown hospital. Patient was diagnosed with heart disease. Treatment of triple bypass was suggested. Patient underwent surgery on August 4, 2021 for a triple bypass and is currently recovering in the hospital.


VAERS ID: 1531779 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Palpitations, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Periorbital and eyelid disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: ~15mins post vaccination pt c/o swelling in the lower eyelid and palpitations (fast HR). Vitals @ 10:10 BP 167/95, HR 122, RR 18 -- $g @10:12 137/93, 98, 18. NO SOB, No c/p Pt monitored and provided water Pt condition improved and in stable condition. Pt released from vaccination site, ED precautions discussed.


VAERS ID: 1531799 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: MEDICATION ERROR. PATIENT CAME INTO CLINIC REQUESTING JANSSEN VACCINE. AFTER ROUTINE INTERVIEW, SHE WAS DEEMED OK TO TAKE THE VACCINE AND IT WAS GIVEN. WHEN THE NURSE WENT TO INPUT THE VACCINE INTO THE STATE REGISTRY, SHE SAW THAT THE PATIENT HAD BEEN GIVEN PFIZER COVID VACCINE 4 DAYS BEFORE AT ANOTHER FACILITY. THE PATIENT WAS CALLED AT HOME AND SAID SHE GOT THE JANSSEN VACCINE ON PURPOSE AFTER THE PFIZER BECAUSE SHE HEARD SHE WOULD GET BETTER COVERAGE IF SHE TOOK MORE THAN 1 KIND OF COVID VACCINE. PATIENT WAS COUNSELED TO CDC RECOMMENDATIONS AND THAT SHE MAY EXPERIENCE AN INCREASE OF SIDE EFFECTS.


VAERS ID: 1531801 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Disorientation, Dizziness, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: 12mins post vaccination pt c/o disorientation, stomach upset, dizziness, blurry vision. Provider assessed and monitored pt. Juice and crackers given. Vitals @4:40pm BP 97/50, HR 63, 98% SpO2 on RA -- $g @4:49pm 91/53, HR 64, 98% -- $g 5:03pm 97/50, 60 -- $g 5:10pm 95/60, 63. Pt reported feeling improvement in sxs. @5:10pm pt verbalized resolution of sxs and no new/abnormal sxs. Provider gave OK to release pt. Pt left w/ mother w/ steady gait, A&Ox4. ED precautions provided.


VAERS ID: 1531804 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-21
Onset:2021-08-02
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone increased, Fatigue
SMQs:, Hypothyroidism (broad), Hyperthyroidism (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: Hashimoto''s disease
Preexisting Conditions: Hashimoto''s
Allergies: No
Diagnostic Lab Data: Had blood done on August 3rd for thyroid levels
CDC Split Type:

Write-up: About two weeks after my vaccine I became very fatigued had blood work done and my thyroid levels went up extremely like they never done before which means I''m running low with my thyroid


VAERS ID: 1531814 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Client was vaccinated at age 11 due to inaccurate date of birth provided by the guardian


VAERS ID: 1531902 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-05
Onset:2021-08-02
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Dysstasia, Fall, SARS-CoV-2 test positive, Vertigo
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 97-year-old male with a past medical history of CKD 3, PVD, hypertension, diabetes not on medication, CHF, hypertension who is a resident of an assisted living facility. He then felt the room was spinning he returned back to his bed and sat down on the edge of the bed and slid off and fell to the floor and could not get up. He did not hit his head and he did not have any loss of consciousness. Chest x-ray showed no acute abnormality. Found to be COVID + , but did not have any respiratory symptoms. Required 1.5L for a few hours (saturation was 98% so I question if he even needed it). He was given Decadron x 10 days.


VAERS ID: 1531986 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH DEW0186 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Cortisone shot
Other Medications: Allegra, Famotadine, Fluticasone, Vitamin C
Current Illness:
Preexisting Conditions:
Allergies: Codeine, cortisone shot, eggs, shrimp, bees
Diagnostic Lab Data: 2 Abbott Rapid-positive Tuesday August 3, 2021 1 PCR- positive - Tuesday August 3, 2021 with result Wednesday August 4, 2021
CDC Split Type:

Write-up: Tested negative for Covid prior to injection. Saturday July 31 with results Sunday August 1. Received shot in the morning fell ill with runny nose, sneezing and fever by 6:30pm. Knowing a stuffy nose was not a vaccine symptom I went went for a Abbott Rapid Covid test Tuesday mid day as I was supposed to fly on Thursday. It was positive. I went back to have another Rapid test and a PCR test all positive.


VAERS ID: 1532106 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-06-04
Onset:2021-08-02
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

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


VAERS ID: 1532120 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-19
Onset:2021-08-02
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM

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

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

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


VAERS ID: 1532150 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dysgeusia, Fatigue, Headache, Muscle tightness, Pain
SMQs:, Taste and smell disorders (narrow), Dystonia (broad)

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

Write-up: Client spoke with PHN on 8/6/21. Reports having "tight jaw" and the taste of metal in his mouth that started when returned to work after completing 30 minute observation period. Client reports symptoms lasted 2 hours. Denied rashes, shortness of breath, denies tingling or numbness at the time. Reports 24 hours after receiving vaccination side effect started of "chilld, headache, bodyache, fatigue" that lasted for 2 days. Client denies s/s illness today. PHN edu to follow up with PMD.


VAERS ID: 1532155 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Heart rate decreased, Hyperhidrosis, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: unknown
Current Illness: none reported
Preexisting Conditions: denied
Allergies: all denied
Diagnostic Lab Data: none
CDC Split Type:

Write-up: COVID-19 Vaccine administered to adolescent; while giving her & mother discharge instructions, pallor set in quickly& she c/o nausea & feeling to vomit. She was diaphoretic to touch, slow pulse <54. While pulling out BP cuff, I gave her an emesis bag, she continued to have feelings of vomiting but never did. 11:40 AM 118/52 pulse slow but not fully counted. 11:42 AM P 56, RR 24, O2 98% Walked to cafeteria table to lie supine. During walk to table (less than 10 steps) her nausea ceased &color returned. 11:49 126/78 , P 62, RR 18, O2 100% ; Water given ; claims she felt much better. skin dry to touch and smiling. 11:53 AM sat up and claims to "feel fine". 11:58 AM 128/72, P 66, RR12 , O2 99% Claims to feel well, no nausea, skin dry to touch, pallor gone. 12:10 PM Released to mother, no further nausea, pallor or diaphoresis.


VAERS ID: 1532178 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 660609 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site nodule, Pain in extremity, Peripheral swelling, Purulence
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Tartrate 100mg, Famotidine 20mg, vit b12 1000mg, Lubiprostone 24mcg, Buspirone Hcl 15mg, Cyclobenzaprine 10mg, Acyclovir 400mg, Ondansetron Hcl 4mg, Trazodone 100mg, Lisinopril 20mg
Current Illness: no
Preexisting Conditions: Gastroparesis, Tardive Dyskinesia, Fibromyalgia, Diverticulitis, High Blood Pressure, Anxiety and Hypertension
Allergies: sulphur
Diagnostic Lab Data: no
CDC Split Type:

Write-up: 2nd day starting have severe pain in the arm, called the pharmacy and the pharmacist told her she was suffering from a side effect from the shot her arm waS swollen he said to put an ice pack on it. Now her right arm has filled up with pus and at the injection site she has a big knot.


VAERS ID: 1532253 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-21
Onset:2021-08-02
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Breast pain, Neck pain, Pain in extremity
SMQs:, Lipodystrophy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Day 2 - day 7 after injection, arm pain, shoulder and neck pain. Day 14 after injection underarm and left breast pain Day 15 after injection underarm and left breast pain like I suffered when I had shingles in the same area, but without the rash. Intense pain alleviated only by moist heat, the same treatment I used when I had shingles. FYI I also had a viral infection following the shingles outbreak.


VAERS ID: 1532482 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-28
Onset:2021-08-02
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaemia, Asthenia, COVID-19, Encephalopathy, Full blood count, Gait inability, Hypernatraemia, Liver function test, Metabolic function test, Pyrexia, SARS-CoV-2 test positive
SMQs:, Haematopoietic erythropenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BMP, CBC, LFTs - 8/5/21
CDC Split Type:

Write-up: Tested positive for COVID, fever, encephalopathic, hypernatremia, anemia, progressive weakness and loss of ability to walk


VAERS ID: 1532673 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Aphthous ulcer, Blood pressure increased, Blood test normal, Chills, Faeces hard, Haematochezia, Illness, Influenza, Lip swelling, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Hypertension (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad)

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

Write-up: Patient became ill the evening after getting the vaccine. She started feeling like a flu was coming on. The next day, 08/03, she had chills, fever, and began shaking. On 8/4/21, she began feeling better, but had canker sores throughout her mouth and a swollen lip. On 8/5/21, she noticed blood in her stool and went to the hospital. They performed blood tests (nothing abnornal) and released her. She had blood in her stool on 8/6/21 consisting of hard clumps of blood. The hospital told her her blood pressure was reading high and told her to see an endocrinologist.


VAERS ID: 1532678 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Dizziness, Euphoric mood, Feeling abnormal, Head discomfort, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Bruising on right arm at age 15 from booster shot.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Constant dizziness and pressure in head, giving a lightheaded or high feeling. Occasional nausea. Trouble concentrating and foggy thinking. Not going away as of 1 week after the shot.


VAERS ID: 1532906 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 1 LA / IM

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

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

Write-up: Patient was injected with vaccine that was beyond the 30 day beyond use date.


VAERS ID: 1533115 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-03-22
Onset:2021-08-02
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir 400mg, Tobrex, Revatio,
Current Illness: Head injury telephone appointment 2/26/21
Preexisting Conditions: Infectious Disease CHRONIC SINUSITIS Musculoskeletal FACET SYNDROME OF CERVICAL SPINE Ear, Nose & Throat OBSTRUCTIVE SLEEP APNEA NASAL SINUS POLYPOSIS NASAL CONGESTION Circulatory BENIGN ESSENTIAL HTN. Digestive SCREENING FOR COLON CANCER Nervous LEFT ULNAR NERVE ENTRAPMENT AT ELBOW Reproductive HYDROCELE TESTICULAR PAIN Respiratory RHINORRHEA
Allergies: NKDA
Diagnostic Lab Data: SARS-COV-2 NAA (COVID-19) Detected 8/4/21 3:45PM
CDC Split Type:

Write-up: headache, cough


VAERS ID: 1533270 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Unknown  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Fatigue, Feeling cold, Feeling hot, Myalgia, Pain in extremity, Skin burning sensation, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Sore muscles Lower back ache Sore arm Tired Slept for about 12 hours Got hot (not fever hot) and felt cold despite being warm Occasional waist burning skin sensation


VAERS ID: 1533289 (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: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

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

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

Write-up: redness, swelling, lump and the spot was hot.


VAERS ID: 1533978 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Cough, Pain, Pain in extremity, Parosmia, Rhinorrhoea, Taste disorder
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (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:
Current Illness: Blood pressure high (Taking maintenance mediation everyday.); Chronic obstructive pulmonary disease
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: 152/80 (High)
CDC Split Type: USJNJFOC20210805868

Write-up: WEIRD SENSE OF SMELL; WEIRD SENSE OF TASTE; RUNNY NOSE; COUGH; SORENESS ON THE LEFT ARM; BURNING PAIN ON THE LEFT ARM; This spontaneous report received from a patient concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included high blood pressure (152/80), and chronic obstructive pulmonary disease (copd). The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and 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 burning pain on the left arm. On 03-AUG-2021, the subject experienced weird sense of smell. On 03-AUG-2021, the subject experienced weird sense of taste. On 03-AUG-2021, the subject experienced runny nose. On 03-AUG-2021, the subject experienced cough. On 03-AUG-2021, the subject experienced soreness on the left arm. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) 152/80 (High). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from burning pain on the left arm on 03-AUG-2021, and had not recovered from soreness on the left arm, weird sense of smell, weird sense of taste, runny nose, and cough. This report was non-serious.


VAERS ID: 1533979 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Unknown  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Feeling hot, Oropharyngeal pain, Pain, Upper-airway cough syndrome
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210805876

Write-up: BODY ACHES; SORE THROAT; FELT WARM BUT NOT FEVERISH; OCCASIONAL DRIP FROM NOSE; This spontaneous report received from a patient concerned a 73 year old of unspecified sex. 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: 043A21A, and expiry: UNKNOWN) dose was not reported, administered on 28-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-AUG-2021, the subject experienced body aches. On 02-AUG-2021, the subject experienced sore throat. On 02-AUG-2021, the subject experienced felt warm but not feverish. On 02-AUG-2021, the subject experienced occasional drip from nose. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from body aches, sore throat, felt warm but not feverish, and occasional drip from nose. This report was non-serious.


VAERS ID: 1534041 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-02-15
Onset:2021-08-02
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Fatigue, Feeling cold
SMQs:, Anaphylactic reaction (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: Ibuprofen, multi vitamin
Current Illness: Gout
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Bp, temp, oxygen levels slightly elevated but good
CDC Split Type:

Write-up: Severe fatigue, cough, chills for two days.


VAERS ID: 1534646 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-29
Onset:2021-08-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Laboratory test, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Depakote/Vimpat/Hydroxychloroquine/ Eloquis (for 1st blood clot received around 1st vaccine) Zyprexa, Levothyroxine, Klonopin, Seroquel, Effexor, Vitamins B D and C,
Current Illness: Lennox Gastaut Syndrome, Sjogrens Syndrome, Lupus, sever sleep apnea, Schizophrenia, Covid
Preexisting Conditions: All of the above, protein S deficient in the past but not currently, Venus thrombosis in 2008 right sinus thrombosis due to severe allergic reaction to Zonegran,
Allergies: Allergies to meds: Lamictal and Zonegran severe(Stevens Johnson?s rash with both) , Trileptal. Adverse reactions to: Fycompa, Keppra
Diagnostic Lab Data: Many. I will provide if needed at a later time.
CDC Split Type:

Write-up: Shortly after receiving 2nd vaccine, developed 2nd superficial blood clot in right leg. Also developed blood clot after receiving 1st vaccine but not sure if the vaccine had anything to do with it or not. Just seems awfully coincidental. Hasn?t had any clots since 2008 until this year.


VAERS ID: 1534648 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Headache, Malaise, Nausea, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alprazolam, Amlopidone, Atrovastatin, Brilinita, Carvedilol, Catapres, Cetrizine, Losartan, Onadansetron, Pantroprazole, Magnesium, multivitamin & Senecot.
Current Illness:
Preexisting Conditions: LAD, CP, Ulcers, colon cancer hx. Spinal DDD
Allergies: Prochlorperazine, NSAIDS including: Naporsyn ( breathing )& Toradol Plus unable to take because of LAD, stomach ulcers
Diagnostic Lab Data:
CDC Split Type:

Write-up: Weakness, headache & nausea & after my 2nd shot my effects were 90% milder but have a light-medium non itchy rash on upper torso unrelated to any other health issues atm feels like blah. 1st shot I was sick 2 weeks afterwards.


VAERS ID: 1534727 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Fatigue, Grip strength decreased, Laboratory test, Mobility decreased, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: post natal vitamin
Current Illness: none
Preexisting Conditions: -umbilical hernia -RhD negative -headache -lymphadenopathy
Allergies: desogestrel-Nausea & vomiting moderate
Diagnostic Lab Data: Lab tests ordered, no results yet.
CDC Split Type:

Write-up: *States developed multiple joint pain and weakness 8 hours after receiving Pfizer COVID19 second dose vaccine 8/2. The day after had a lot of fatigue, generalized myalgias. The day after that every single joint in her body hurt which made it very hard to ambulate around. Could not lift the covers of her bedsheets to her shoulders because of the pain. Took ibuprofen last night which helped a bit but still having significant joint pain and feels the hands are weak with no strength. NO active swelling noted. *No fevers/chills. NO headaches or vision changes. No sciatica or radiculopathy. No swelling of extremities. No rashes. No SOB, chest pain or palpitations. *On exam afebrile. No synovitis noted. 4/5 motor strength b/l upper ext. with decreased grip strength b/l hands. *Will check further labwork. As nursing will avoid meloxicam and trial oral prednisone and advised to hold breastfeeding until 4 hours after taking prednisone. Close clinical f/u


VAERS ID: 1534751 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Eye discharge, Fatigue, Fibromyalgia, Hypersomnia, Ocular hyperaemia, Pain, Pyrexia, Swelling, Swelling face, Temperature intolerance
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fatigue : sleeping average of 18 hours per day Fever: 102-103 Puffy face and neck Red pasty eyes like pink eye Increased pain and fibromyalgia symptoms Heat intolerant


VAERS ID: 1534756 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-19
Onset:2021-08-02
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Anosmia, COVID-19, Chest pain, Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: Tested positive for COVID. subjective fever, muscle aches, runny nose, sore throat, loss of taste and smell, headache, fatigue, cough, wheezing, shortness of breath, chest pain, abdominal pain, diarrhea


VAERS ID: 1534810 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-17
Onset:2021-08-02
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZ1A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Severe bloody nose, 3 consecutive days.


VAERS ID: 1534812 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse event, Pain, Peripheral swelling, Pruritus, Rash, Rash erythematous, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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 came into the store on 08/06 to report an adverse event. She showed me her arm and there was a noticeable red rash about 3 inches in diameter. Patient also reported that her arm was also slightly swollen, warm to the touch, and itchy. She said it began about 5 days prior to coming to the pharmacy. She said it had gradually grown in size. Patient was instructed to take 25mg of diphenhydramine and ibuprofen to reduce the pain, inflammation, and itching.


VAERS ID: 1534847 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-26
Onset:2021-08-02
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: Type 2 diabetes mellitus, without long-term current use of insulin; without retinopathy Essential hypertension (Chronic) Interstitial lung disease (*) Nodular organizing pneumonia with associated small airways remodeling
Allergies: KNDA
Diagnostic Lab Data: rapid PCR COVID-19 test Chest xray is pending
CDC Split Type:

Write-up: Patient now admitted to inpatient general medical unit for complications of COVID-19 which was diagnosed in the ER via rapid PCR testing prior to admission. Imaging is underway to determine pneumonia. Limited presenting information from partial ER note: Onset: 4/5 days (~ 8/2/21) Sx: increased general weakness, decreased activity level and tolerance Social: not documented at time of chart review Immz: fully vaccinated; patient being admitted; e-VAERS report entered


VAERS ID: 1534857 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN ZU3AZIA / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Muscle spasms
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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 c, multivitamin, zinc, quercetin
Current Illness: Sinus infection
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Have no visited a doctor yet
CDC Split Type:

Write-up: Muscle spasms and cramps in abdomen and legs


VAERS ID: 1534981 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest X-ray normal, Confusional state, Cough, Dizziness, Dyspnoea, Fatigue, Gait disturbance, Headache, Heart rate increased, Insomnia, Malaise, Myalgia, Pain in extremity, Paranasal sinus discomfort, Pruritus, Pyrexia, Rash, SARS-CoV-2 test negative, Swelling, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: T-day during pregnancy in 2015 (rash, swelling in arm only)
Other Medications: N/a
Current Illness: Positive COVID-19 diagnosis March/April 2020, positive antibody testing for months thereafter. No active illness at all during months leading up to vaccination.
Preexisting Conditions: Genetic high blood pressure, previous myocarditis due to natural covid-19 infection then a 2nd time after donating plasma, diastolic dysfunction, May-Thurner Syndrome treated with 4 vascular stents. Pressured by government and employer to receive vaccine despite much hesitation. Natural infection and immunity had kept me well and uninfected for over a year after recovering from covid.
Allergies: T-dap, Sulpha, butrans patch adhesive
Diagnostic Lab Data: Urgent Care - chest x-ray to rule out pneumonia -physical exam -COVID-19 test (came back negative) -alternative reasons for return of covid-cough post vaccine -Blood pressure readings, pulse, oxygen levels
CDC Split Type:

Write-up: Within an hour of 1st vaccine dose all my pre-covid symptoms reoccurred. I had covid-19 starting March 24, 2020, tested positive 7 days later after searching for a test kit. Tested positive followed by almost a year of positive antibody testing. It took my lungs almost 4 months to return to normal after having the coronavirus. My symptoms following the vaccine imitated my experience with actually contracting the virus. They were the following, most experienced within the first hour of the vaccination on August 2, 2021. The normal expected side effects of arm pain from injection, fatigue, headache, etc. However, my COVID-19 cough from the initial real infection returned with a vengeance, fever of 103/104 degrees, inability to walk up flight of stairs, dizziness, full body swelling, itching, rashes, shortness of breath, high heart rate, trouble breathing deeply due to coughing, joint pain, muscle pain, extreme sinus like pressure exactly like when I had covid-19 (much more than a normal "headache"), trouble sleeping, blurry vision, mental confusion for days, and more. The seriousness of side effects despite Tylenol, Advil and rest over days sent me to an urgent care for testing. A PCR test indicated I was negative for COVID-19, possible respiratory virus from the vaccine was reported as well as systemic inflammatory syndrome. I was sent home and now 5-6 days later still not improving.


VAERS ID: 1535040 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 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: Not known
Current Illness: None
Preexisting Conditions: Not known
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient collapsed after getting the shot when she got up from the consulting room to go to the waiting area


VAERS ID: 1535063 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-08-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Body temperature fluctuation, Chest X-ray, Chills, Computerised tomogram head, Headache, Lumbar puncture, Neck pain, Pain, Tremor, Urine analysis, Viral test
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantoprozole, Cialis, Losartan HTCL
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest x-ray, CT scan of the head, and lumbar puncture, blood work up, urine analysis, nose swab to check for 17 other viruses
CDC Split Type:

Write-up: 102 temperature, fluctuating down to 95.6 and then back up to 101.6, headaches, chills and shakes, bodyaches and severe neck pain that lasted for five days ended up in the emergency room to rule out meningitis.


VAERS ID: 1535081 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-19
Onset:2021-08-02
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate decreased, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: oxycodone, Xanax, diclofenac, gabapentin,
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: low heart rate and weight loss from 8/2/21-8/7/21


VAERS ID: 1535189 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Asthenia, Blood test normal, Computerised tomogram normal, Decreased appetite, Diplopia, Dizziness, Dysarthria, Dysgeusia, Fatigue, Hypoacusis, Muscular weakness, Parosmia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (narrow), Vestibular disorders (broad), Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol and Iron
Current Illness: none
Preexisting Conditions: POTS Syndrome, Degenerative Disk Disease
Allergies: Bactrim
Diagnostic Lab Data: CT scan normal, blood levels normal
CDC Split Type:

Write-up: Fatigue, weak, dizzy, lightheaded, slurring words, blurred vision, double vision, hearing off, smell and taste is a chemical smell and taste, memory lapse, arms and legs feel like jello, not eating, continually getting worse.


VAERS ID: 1535229 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-27
Onset:2021-08-02
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Incisional drainage
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Her cancer treatment center sent her to the emergency room for nonhealing wound. Patient presents with draining non healing wound requiring incision and drainage with IV antibiotics. Pt wsa hospitalized 6 days.


VAERS ID: 1535239 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 80777-0273-15 / 7+ LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Dysstasia, Fatigue, Gait disturbance, Headache, Mobility decreased, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna July 2021
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none know
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I received the 2nd shot of the Moderna CoVid 19 vaccine on Sunday, August 1, 2021. The next morning Monday, August 2, 2021 I woke up as usual about 6:30 a.m. and could not barely get out of bed by myself. By 8:00 a.m. I needed assistance from my wife to get up from bed and to walk. Other symptoms during the day were: Headache, fatigue, muscle and joint pain, chills, and fever. By the afternoon this symptoms continued and my fever remained over 100 degrees and when to 102.3 degrees. Symptoms including walking and standing issues continued until I when to bed around 11:00 p.m. On Tuesday morning, August 2, 2021 was able to walk by other symptoms remained. The rest of the week including today August 8, 2021 side effects have continued.


VAERS ID: 1535384 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Injection site induration, Injection site warmth, Pain in extremity, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women Vitamin Probiotic
Current Illness:
Preexisting Conditions: Weak immune system- MM Migraines Gerd
Allergies: No
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Sore arm for the first 3 days following shot. Then around fourth day arm started to become red, swelled, and itchy. At the injection site arm feels like a hard knot which is warm and feverish from around day 4 up to current date of this report. I have taken tylenol, motrin, zyrtec, benadryl, and applied ice.


VAERS ID: 1535424 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA71185 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Erythema, Eye pruritus, Immediate post-injection reaction, Palpitations, Paraesthesia, Pruritus, Vulvovaginal pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Lipodystrophy (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: Daily vitamin, zyrtec allergy, Viactiv, Latanoprost, Restasis
Current Illness: none
Preexisting Conditions: dry eye
Allergies: Sulfa drugs, penicillin, mycin drugs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: IMMEDIATE Hives on both arms. Left arm immediately felt very tight....felt like a tourniquet was tied around my elbow and fingers started tingling. Within 5 minutes eyes, mouth, ears and vaginal area very itchy and became dark pinkish/light red. Advised pharmacist on duty. Was advised to go home and take 2 Benadryl every 4-6 hours. Heart began racing within 30 minutes. Heart racing lasted 5 days. Hives are still in all the above areas. Still taking Benadryl. Still itchy, Fingers are still still tingly on left hand. Left arm still feels weaker. Left armpit is still sore. Left breast is still having off and on pain and hives on nipples.


VAERS ID: 1535476 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscular weakness, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol 50 mg , atorvastatin 20 mg, losartan 100 mg, omeprazole 20
Current Illness: none
Preexisting Conditions: allergies.
Allergies: none
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: arm extremely sore day after shot. could not hardly move my arm for 5 days. on the 6th day pain subsided some but extremely painful to move it certain ways. muscle also weak.


VAERS ID: 1535609 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Altered state of consciousness, Blood test normal, Body temperature increased, Chest discomfort, Dyspnoea, Electrocardiogram normal, Heart rate increased, Hypopnoea, Muscle spasms, Oxygen saturation normal, Panic attack, Seizure, Yawning
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dystonia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Oregano oil 2x daily Probiotic and prenatal daily Cranberry supplement daily Allergy pill daily Occasional use if Excedrin and extra strength ibuprofen/acetaminophen
Current Illness:
Preexisting Conditions: Possible Ehlers Danlos Syndrome, still not diagnosed
Allergies: Some nuts, oral allergy to some fruit
Diagnostic Lab Data: I was pretty out of it at the hospital, can''t recall everything they did. Blood work was done, I was told it was normal. Oxygen levels read as normal. Fever went down in a few hours. IV fluids given. EKG normal.
CDC Split Type:

Write-up: Mon. 8/2 in the evening unusual heaviness in my chest, shallow breathing. Tue. 8/3 in the evening about 10pm panic attack. First ever panic attack. Recorded temp in the ambulance was 100.6. Resting heat rate of 165. Involuntary leg convulsions starting at my hip flexors. Almost like repeated Charley horses that stopped and started at random. According to ER nurse I had a panic attack related to marijuana consumption and preexisting anxiety. I think it''s worth noting that I''ve had anxiety for 15 years and I''ve smoked weed for 10. I have never had a panic attack. I have never had trouble breathing. I have never suddenly out of the blue had a resting heart rate of 165. Since the "panic attack" I haven''t been able to breathe normally. My chest has a constant heaviness. I am gasping for air and yawning all day, and not because I''m tired, it seems to be my body''s effort to get adequate oxygen into my lungs.


VAERS ID: 1535611 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-29
Onset:2021-08-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20614211A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aleve, Vitamins D, C, zinc, turmeric and magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Lump at injection site, pain from shoulder blade , down arm to fingertips. Extreme pain in shoulder and elbow 10 days post injection


VAERS ID: 1535658 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Booster Given Too Early-


VAERS ID: 1535674 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Eye swelling, Mouth swelling, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Severe, Additional Details: Previously reported, but patient provided further details at a later date. She had to report to ER due to swelling of face and tongue. Diagnosed with angioedema and had to be treated with benadryl, solu-medrol, and famotidine at the ER


VAERS ID: 1535928 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-08-02
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / UN

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Headache, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: SOB, weakness, nausea, headaches, fever up to 103.


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