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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 296 out of 7,116

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VAERS ID: 1549259 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-15
Onset:2021-08-02
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Novel Coronavirus PCR- Detected (8/2/2021)
CDC Split Type:

Write-up: Patient is an 77 yo female s/p full Pfizer COVID vaccination: dose 1 on 1/25/2021 and dose 2 on 2/15/2021. Pt with new onset symptoms of fever, cough, and headache. Denies known exposure to COVID-19. PCR test results positive on 8/2. Pt receives casirivimab/imdevimab infusion on 8/3.


VAERS ID: 1549261 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-08-02
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: POCT SARS-COV-2 RAPID- Detected 8/2/2021
CDC Split Type:

Write-up: Pt is 30 yo female s/p full Moderna COVID vaccination: dose 1 on 1/22/2021 and dose 2 on 2/19/2021. Pt is an employee of this institution reporting new onset headache, sore throat, and congestion/runny nose. She confirms possible exposure to COVID-19. Pt has agreed to receive casirivimab/imdevimab infusion.


VAERS ID: 1549264 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-08-02
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Cough, Echocardiogram, Infusion, SARS-CoV-2 test positive, Syncope, Ultrasound Doppler
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, peptic lcer disease, mixed HLD, degenerative disc disease, CKD (stage 3), obesity
Allergies:
Diagnostic Lab Data: Novel Coronavirus PCR- Detected 8/2/2021
CDC Split Type:

Write-up: Pt is a 72 yo male s/p full Moderna COVID vaccination: dose 1 on 2/10/2021 and dose 2 on 3/10/2021. Pt initially presented to the ED on 8/2 for syncopal episode. He was monitored overnight and cardiac echo and carotid Dopplers were completed. At admission he tested positive for COVID and was asymptomatic other than a slight nonproductive cough. Pt received casirivimab/imdevimab infusion on 8/3.


VAERS ID: 1549266 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-08-02
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sulfa antibiotics
Diagnostic Lab Data: Novel Coronavirus PCR - Detected 8/2/2021
CDC Split Type:

Write-up: Pt is a 39 yo female s/p full Moderna vaccination: first dose on 1/2/2021 and second dose on 2/1/2021. Pt is employee of this institution. On 7/30 reports no new onset of symptoms however confirms exposure to COVID positive person. A few days later starts experiencing symptoms and PCR test results positive on 8/2.


VAERS ID: 1549269 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-08-02
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 204A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Fatigue, Headache, Myalgia, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, 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), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Sulfa antibiotics
Diagnostic Lab Data: Novel Coronavirus PCR - Detected (8/2/2021)
CDC Split Type:

Write-up: Pt is 40 yo male s/p J&J COVID vaccination on 5/21. Pt is an employee of this institution. On 8/2, reports new onset symptoms of fever, chills, cough, SOB/difficulty breathing, fatigue, muscle/body aches, headache, sore throat, and congestion/runny nose. He denies any known exposure to COVID. PCR test results positive on 8/2. Pt is identified as candidate for casirivimab/imdevimab infusion, however, declines treatment.


VAERS ID: 1549368 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-26
Onset:2021-08-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyspepsia, Erectile dysfunction, Flatulence, Gastrooesophageal reflux disease, Loss of libido
SMQs:, Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Sexual dysfunction (narrow)

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

Write-up: total loss of libido - can not achieve an erection serious stomach indigestion - acid reflux/gas


VAERS ID: 1549370 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-15
Onset:2021-08-02
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Fatigue, Hypoxia, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, alprazolam, amlodipine, azithromycin, clonidine, cl
Current Illness:
Preexisting Conditions: CAD, MI in 2003 s/p stent placement on Plavix, HTN, HLD, morbidly obese, GERD
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/2/21: Patient arrived at the ER due to hypoxia secondary to COVID-19 infection. Patient notes his symptoms started 3 weeks ago with sore throat and fatigue. Patient tested positive for COVID-19 on 7/28/2021. Diagnosed with: COVID-19 pneumonia, acute hypoxic respiratory failure Please note: Patient received First dose of Pfizer COVID-19 vaccine on 1/23/2021, followed by the second dose on 2/15/2021 (confirmed through DOH) 8/9/2021: patient discharged


VAERS ID: 1549447 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: The patient came in 14 days after his first dose of the Pfizer Covid vaccine to receive his second dose. We did not use the Immunization Selection Tool provided by pharmacy to determine that he was 7 days early for his second dose and the dose was given. The patient did not have and has not had any adverse reactions after receiving his second dose 7 days early.


VAERS ID: 1549468 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-13
Onset:2021-08-02
   Days after vaccination:111
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6599 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Chills, Condition aggravated, Diarrhoea, Dyspnoea, Flank pain, Headache, Inappropriate schedule of product administration, Nausea, Nephrolithiasis, Pain, Productive cough, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Medication errors (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, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, alprazolam, azithromycin, cefdinir, clopidogrel, ferrous sulfate, gabapentin, levothyroxine, lisinopril, ondansetron, oxycodone-acetaminophen, pantoprazole, pravastatin, sucralfate
Current Illness:
Preexisting Conditions: COPD, CAD sp 3 stents, hypertension, hyperlipidemia, hypothyroidism, nephrolithiasis, anxiety, and neuropathy
Allergies: no known allergies
Diagnostic Lab Data: COVID PCR + 8/2/2021
CDC Split Type:

Write-up: 8/2/2021: presented to ED with CC of shortness of breath. Symptoms began 4 days prior to presentation, patient began experiencing shortness of breath & cough productive of white sputum, body aches, and fever/chills. Patient endorses intermittent headaches, nausea, and diarrhea for the past 2 days and intermittent left flank pain he attributes to his recurrent nephrolithiasis. Diagnosed with acute hypoxic resp failure 2/2 COVID-19 Note: patient previously vaccinated with Pfizer COVID-19 vaccine on 3/3/21 and 4/13/21. 8/12/2021: patient discharged


VAERS ID: 1549655 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-02
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Headache, Nasal congestion, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/06/21 pfizer,Lot#EL3248 2nd dose 01/27/21 Pfizer,lot#EL9262 Diagnosed covid positive:08/04/21 Symptom onset:08/02/21 Exposure:unknown Symptoms:Fever, cough, sore throat, chills,headache ,stuffy nose


VAERS ID: 1549673 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-04
Onset:2021-08-02
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Myalgia, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/07/21 ModernaLot# 2nd dose02/04/21 Moderna lot# Diagnosed covid positive:08/02/21 Symptom onset:08/02/21 Exposure:Travel Symptoms:SOB,muscle aches,sore throat


VAERS ID: 1549675 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-13
Onset:2021-08-02
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/24/20 pfizer,Lot#EK9231 2nd dose 01/13/21Pfizer,lot#EL3248 Diagnosed covid positive:08/02/21 Symptom onset: Exposure:Home Symptoms: Asymptomatic


VAERS ID: 1549844 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-25
Onset:2021-08-02
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Diarrhoea, Dyspnoea, Nasal congestion, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Vertigo
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (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), Vestibular disorders (narrow), Noninfectious diarrhoea (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: inhaler for asthma
Current Illness: none known
Preexisting Conditions: periodic asthma
Allergies: none known
Diagnostic Lab Data: PCR + for Covid 8/4/2021
CDC Split Type:

Write-up: Client vaccinated with Moderna vaccine for Covid on 2/25 and 3/26/2021 at public health clinic at Client started having Covid symptoms (nasal congestion, diarrhea, fever x 1 day, vertigo, sore throat, loss of taste and smell, occasional SOB) on 8/2/2021. Tested positive PCR on 8/4. Reported as a case of breakthrough Covid in a previously vaccinated person.


VAERS ID: 1550079 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Idaho  
Vaccinated:0000-00-00
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Injection site pain, Insomnia
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (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: Comments: The patient had no known drug allergies, no known medical conditions and does not take any medications at the time of reporting.
Allergies:
Diagnostic Lab Data: Test Date: 20210802; Test Name: Body temperature; Result Unstructured Data: high
CDC Split Type: USJNJFOC20210805908

Write-up: INSOMNIA/LOSE SOME SLEEP; HIGH BODY TEMPERATURE; INJECTION SITE PAIN; This spontaneous report received from a patient concerned a 39 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies, no known medical conditions and does not take any medications at the time of reporting.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A 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 insomnia/lose some sleep. On 02-AUG-2021, the subject experienced high body temperature. On 02-AUG-2021, the subject experienced injection site pain. Laboratory data included: Body temperature (NR: not provided) high. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from high body temperature, and insomnia/lose some sleep, and the outcome of injection site pain was not reported. This report was non-serious.


VAERS ID: 1553795 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-27
Onset:2021-08-02
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, COVID-19, Dyspnoea, Nausea, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: 80-year-old male with past medical history of hypertension presents to the emergency department with worsening shortness of breath. Patient is Spanish-speaking interview was held with translation device. Patient tested COVID positive a few days ago and has been tolerating home remedies at but symptoms have continued to get worse prompting him to come to the emergency department. Other family members at home are complaining flu-like symptoms. No one else has been diagnosed COVID positive. Also complaining of some abdominal discomfort with nausea and vomiting 8/2/2021 tested positive


VAERS ID: 1553824 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-31
Onset:2021-08-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Angina pectoris, Blood test abnormal, Chest pain, Echocardiogram normal, Electrocardiogram normal, Fatigue, Headache, Myocarditis, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Patient was given an 2 EKG''s, and echo cardiogram, and blood work was taken 3 times while at the hospital. EKG and echo cardiogram came back normal. Blood work labs from the first and second take showed elevated numbers indicating inflammation around the heart. Blood work was taken 8 hours apart. The third blood work lab showed numbers were in the normal range. Patient was discharged from the hospital.
CDC Split Type:

Write-up: Patient presented common side effects the first 24 hours (headache, mild fever, tiredness, vomiting & nausea). On 8/2/21 around 2pm, patient began complaining that his "heart hurt". He laid down to rest, but his chest continued to hurt and the pain level increased. By 8:30 pm that same day, patient''s heart hurt to the point of crying and he was taken to the emergency room. At Hospital, patient was diagnosed with Myocarditis as a result of the second dose of the Covid-19 vaccine.


VAERS ID: 1553853 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-28
Onset:2021-08-02
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, Dizziness, Dizziness postural, Dyspnoea, Hyperhidrosis, Hypokalaemia, Nausea, Oropharyngeal pain, Orthostatic hypotension, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (narrow), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: escitalopram, hydrochlorothiazide, hydroxyzine, montelukast
Current Illness:
Preexisting Conditions: anxiety, depression, arthritis, asthma, hypertension, Dehydration, GERD, anemia, multiple myeloma in remission, subacute cutaneous lupus erythematosus.
Allergies: Ketoprofen, lisinopril
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt completed the J&J Janssen series, with one dose on 3/28/2021. This dose was received in another state, so no lot number is available. On 8/2/2021, pt presented to a local hospital ED for a covid test after a close exposure to someone positive. Mild symptoms at the time, "sore throat, shortness of breath, cough,dizzy/sweaty.". Returned to the ED on 8/9/2021 and was transferred to our hospital for inpatient care on 8/10/2021. Required gen med level of care. "presents with a chief complaint of ongoing diarrhea, nausea, vomiting and followed at the outside facility emergency room to have hypokalemia, orthostatic hypotension symptoms of dizziness and lightheadedness with standing and fever in the setting of Covid positive test."


VAERS ID: 1553890 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-31
Onset:2021-08-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 10mg
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, amoxicillin, tree nuts, poppy seeds.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen Lymph nodes on collarbone and neck on left side.


VAERS ID: 1553896 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-24
Onset:2021-08-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chromaturia, Fatigue, Feeling abnormal, Gout, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Hearing impairment (narrow), Arthritis (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: Praluent, Slow FE Iron supplement
Current Illness: none
Preexisting Conditions: High cholesterol
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus, darkened urine, gout, fatigue, brain fog.


VAERS ID: 1554152 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-08-02
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Vaccinated in Feb/March 2021 and later hospitalized with N17.9 - AKI (acute kidney injury) (CMS/HCC) U07.1 - COVID-19


VAERS ID: 1554185 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-30
Onset:2021-08-02
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CKD stage 3, DM, GERD, HTN, Obesity, hypothyroidism, chronic anticoagulation, cancer left breast, anemia,
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient tested positive for COVID-19 after vaccination


VAERS ID: 1554281 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-18
Onset:2021-08-02
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / -

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

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

Write-up: J18.9 - Pneumonia U07.1 - COVID-19


VAERS ID: 1554300 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-26
Onset:2021-08-02
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Cerebrovascular accident, Facial paresis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: I63.9 - CVA (cerebral vascular accident) R29.810 - Facial weakness N17.9 - Acute kidney failure, unspecified


VAERS ID: 1554304 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-08-02
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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

Write-up: Cerebrovascular accident (CVA), unspecified mechanism


VAERS ID: 1558060 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

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

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

Write-up: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient noted the day after receiving the vaccine that she started to form 2 "knots" near the injection site, which eventually merged into one. The site is now just red with a dark red circle on her warm. Site is warm to the touch. Patient notes of taking benadryl at night, which helps it and clears it up a bit by the time she wakes up, but forms again during the day.


VAERS ID: 1558089 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-28
Onset:2021-08-02
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Minor COVID symptoms, cough, aches, hard to breathe, fatigue


VAERS ID: 1569084 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Peripheral swelling, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data: Ultra sound for blood clots. None found but foot still swollen
CDC Split Type:

Write-up: Swollen left foot


VAERS ID: 1569193 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-16
Onset:2021-08-02
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Deafness unilateral, Rhinitis, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hearing impairment (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: lamictal, effexor, omega 3,6,9, DIM menopausal supplement, zyzal, niacin
Current Illness: n/a
Preexisting Conditions: Sarcoidosis, arthritis, migraines
Allergies: latex, some adhesives, some bandages and tape, all opiods - extreme itching
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: rhinitis, loss of hearing in one ear for one day, hives on and off for two weeks


VAERS ID: 1569212 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-29
Onset:2021-08-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NO SIGNIFICANT
Allergies: NONE
Diagnostic Lab Data: CLINICAL OBSERVATION NO TESTING REQUIRED.
CDC Split Type:

Write-up: I HAD A PAINFUL VESSICULAR RASH IN THE RIGHT C4 OR C5 DERMATOME CONSISTENT WITH HERPES ZOSTER. I HAD CHICKEN POX AS A CHILD, AND NEVER HAVE HAD SHINGLES BEFORE THIS.


VAERS ID: 1569263 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-15
Onset:2021-08-02
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK8735 / 1 AR / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. developed partial facial paralysis on her left side, around 1-2 weeks after her first COVID-19 vaccine injection.


VAERS ID: 1573831 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deafness, Hypoacusis, Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Patient reported on 8/2/2021 the day after she had received her 2nd dose of Pfizer vaccine she had ?muffled? sound in ears , then developed into ringing in ears. She is seeing an ENT for this. He stated she has some hearing loss.


VAERS ID: 1573859 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-10
Onset:2021-08-02
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 2 RA / SYR

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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin; Enbrel; duloxetine; meloxicam; pantoprazole; vitamin e; fish oil
Current Illness: None
Preexisting Conditions: Psoriasis; high cholesterol; heart murmur; arthritis; depression
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type: vsafe

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


VAERS ID: 1573915 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-22
Onset:2021-08-02
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Dental examination, Headache, SARS-CoV-2 test negative
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Cytomel, Zyrtec, multivitamin
Current Illness:
Preexisting Conditions: Hashimoto''s thyroiditis, seasonal allergies
Allergies: Leviquin
Diagnostic Lab Data: 9 Aug 2021 - General dentist checked for cracked tooth/dental issues; none found 10 Aug 2021 -Rapid COVID test came back negative. 26 Aug 2021 - pending follow up dr''s appointment to address persistent headaches
CDC Split Type:

Write-up: Persistent headache - still occurring more than three weeks later. Muscle relaxers, Tylenol PM, Aleve, Motrin, RX migraine meds do nothing to relieve the headache


VAERS ID: 1573920 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: Patient given an expired dose of vaccine.


VAERS ID: 1574123 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Headache, Heart rate increased, Hypertension, Nausea, Tinnitus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Hearing impairment (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin 10 mg in the evening
Current Illness: None
Preexisting Conditions: High cholesterol been 1 year
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache (doesn''t go away after Tylenol), fast heart beat, tight in the chest, ears ringing, feeling throwing up, high blood pressure150/93 pulse 83 (measures twice a day)


VAERS ID: 1574245 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 3 LA / IM

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

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

Write-up: Patient received a 3rd dose of Moderna. 1st dose on 1/18/21, 2nd dose of 2/15/21, 3rd dose on 8/2/21.


VAERS ID: 1574257 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Paraesthesia, Rash, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no medications
Current Illness: no illness
Preexisting Conditions: no
Allergies: no allergies
Diagnostic Lab Data:
CDC Split Type: 131622807262

Write-up: Prickling on the inside of the skin that turned into bumps much like chickenpox but small with fluid in the upper part of the body spread out on the left arm and right arm, and the rest of the body only a few of them.


VAERS ID: 1574343 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-02
Onset:2021-08-02
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Hyperthermia, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine besylate (AMLODIPINE ORAL) aspirin 81 mg tablet atorvastatin (LIPITOR) 40 mg tablet CHOLECALCIFEROL, VITAMIN D3, (VITAMIN D3 ORAL) gabapentin (NEURONTIN) 300 mg capsule irbesartan-hydrochlorothiazide (AVALIDE) 150-12.5 mg per tab
Current Illness:
Preexisting Conditions: Circulatory Hypertension Murmur Musculoskeletal Basal cell carcinoma of left preauricular region Multiple acquired skin tags Neoplasm of uncertain behavior of skin Osteopenia Endocrine/Metabolic Hypercholesterolemia Other Carcinoma in situ of breast History of breast cancer in female
Allergies: NKA
Diagnostic Lab Data: 08/02/21 2045 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/02/21 1744 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/02/21 2045 COVID-19 PCR Collected: 08/02/21 1744 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Hyperthermia-induced defect


VAERS ID: 1574355 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 AR / IM

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

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

Write-up: Patient obtained 1st dose Pfizer vaccine at 0915am. As per patient, she is to be monitored 45min to 1hour, instructed by her allergy doctor. At 10:36, medical alert was called. Patient was complaining of Headache and dizziness. Pain level of headache was a 9. 1037 BP 158*/68 HR 82 SAT 99%. Patient alert and oriented. 1042am BP 156/77 HR 74 Pain level 6. At 1046 BP 148/80 HR 77. Patient stated her headache was better. Patient left with her friend who was scheduled to pick her up. End time is 1047am.


VAERS ID: 1574368 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-27
Onset:2021-08-02
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Adenovirus test, Atelectasis, Bordetella test negative, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chlamydia test negative, Coronavirus test negative, Dyspnoea, Dyspnoea exertional, Enterovirus test negative, Human metapneumovirus test, Human rhinovirus test, Hypoxia, Influenza A virus test negative, Influenza B virus test, Leukocytosis, Lung infiltration, Mycoplasma test negative, Pneumonia, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Sepsis, Tachypnoea, Viral test
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: apixaban (ELIQUIS) 5 mg tablet aspirin 81 mg chewable tablet bumetanide (BUMEX) 1 mg tablet ELIQUIS 2.5 mg tablet hydrALAZINE (APRESOLINE) 10 mg tablet isosorbide mononitrate (IMDUR) 30 mg 24 hr tablet levothyroxine (SYNTHROID) 100 mcg tabl
Current Illness:
Preexisting Conditions: Non-Hospital ADD (attention deficit disorder) Anticardiolipin antibody positive Antiphospholipid syndrome (CMS/HCC) Chronic ITP (idiopathic thrombocytopenia) (CMS/HCC) Coronary disease DVT (deep venous thrombosis) (CMS/HCC) Erectile dysfunction Essential hypertension Hx of bladder cancer Hypothyroidism Iron deficiency anemia Ischemic cardiomyopathy Lipodermatosclerosis Myocardial infarction (CMS/HCC) Nonrheumatic aortic valve insufficiency PAF (paroxysmal atrial fibrillation) (CMS/HCC) Pulmonary embolism (CMS/HCC) Stage 3 chronic kidney disease SBO (small bowel obstruction) (CMS/HCC) Acute exacerbation of CHF (congestive heart failure) (CMS/HCC
Allergies: Iodinated Contrast MediaHives / Urticaria, Rash Venom-honey BeeAnaphylaxis, Swelling AtomoxetineHives / Urticaria, Itching, Rash IohexolHives / Urticaria Quinidine-quinine Analogues (Cinchona Alkaloids)Other (document details in comments) Amoxicillin-pot ClavulanateItching
Diagnostic Lab Data: 08/02/21 1153 Respiratory virus detection panel Collected: 08/02/21 1033 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected X-ray chest 1 view - portable [3296598078] Resulted: 08/07/21 2134 Order Status: Completed Updated: 08/07/21 2135 Narrative: XR CHEST 1 VW PORT IMPRESSION: There is interval increase of patchy infiltrates in both lower lobes more on the left side and left perihilar region identified. END OF IMPRESSION: INDICATION: Hypoxia, Acute shortness of breath. TECHNIQUE: AP projection of the chest is acquired. COMPARISON: 8/5/2021 FINDINGS: There is interval increase of patchy infiltrates in both lower lobes more on the left side and left perihilar region identified. No effusions or pneumothorax. Mild cardiomegaly and right central venous tunnel catheter tip in lower SVC. Rib cage is unremarkable. X-ray chest 2 views [3296264298] Resulted: 08/07/21 0102 Order Status: Completed Updated: 08/07/21 0102 Narrative: XR CHEST 2 VW IMPRESSION: Increased patchy bibasilar opacity may reflect pneumonia or atelectasis. END OF IMPRESSION: INDICATION: Dyspnea, on exertion, fever workup. TECHNIQUE: AP and lateral views of the chest are acquired. COMPARISON: 8/2/2021. FINDINGS: There is mild increased patchy bibasilar opacity which may reflect atelectasis or pneumonia. The right central line tip is in the SVC. The cardiac silhouette is enlarged. There is no marked central vascular prominence. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 2 views [3295646179] Resulted: 08/02/21 1101 Order Status: Completed Updated: 08/02/21 1101 Narrative: XR CHEST 2 VW IMPRESSION: Mild bibasilar lung opacities greater on the left than right compatible with infiltrates or atelectasis. END OF IMPRESSION: INDICATION: SOB. TECHNIQUE: PA and lateral projections of the chest are acquired. COMPARISON: 11/20/2020 FINDINGS: There are mild bibasilar opacities greater on the left than right compatible with infiltrates or atelectasis. Normal heart size and cardiomediastinal silhouette. No pneumothorax is trace right pleural effusion. Regional osseous structures are unremarkable.
CDC Split Type:

Write-up: ED to Hosp-Admission Current 8/2/2021 - present (14 days) the Hospital Chief Complaint Patient presents with ? Shortness of Breath Sepsis secondary to pneumonia, presenting with tachypnea and leukocytosis and acute kidney injury Community-acquired pneumonia versus COVID-19 pneumonia ?Admit to medical service


VAERS ID: 1574418 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-18
Onset:2021-08-02
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Rhinorrhoea, SARS-CoV-2 test positive, Throat irritation
SMQs:, Anaphylactic reaction (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinoL (ZYLOPRIM) 300 mg tablet aspirin 81 mg chewable tablet atorvastatin (LIPITOR) 40 mg tablet(Expired) blood sugar diagnostic (ONETOUCH VERIO TEST STRIPS) strip cholecalciferol, vitamin D3, 50 mcg (2,000 unit) capsule coenzyme Q10
Current Illness:
Preexisting Conditions: Nervous Chest pain on breathing Hearing loss Chronic bilateral low back pain without sciatica Chronic pain of both knees Cerebrovascular accident (CVA) due to stenosis of left middle cerebral artery (CMS/HCC) Respiratory Sleep apnea Circulatory Atrial fibrillation, persistent (CMS/HCC) Essential hypertension Aortic aneurysm without rupture (CMS/HCC) Abdominal aortic aneurysm without rupture (CMS/HCC) Chronic combined systolic and diastolic congestive heart failure (CMS/HCC) Peripheral vascular disorder due to diabetes mellitus (CMS/HCC) Hypertensive heart disease Hypertensive urgency Mesenteric artery stenosis (CMS/HCC) Orthostatic hypotension Presence of Watchman left atrial appendage closure device Digestive GERD (gastroesophageal reflux disease) Vitamin D deficiency Genitourinary CKD (chronic kidney disease) stage 3, GFR 30-59 ml/min Musculoskeletal Squamous cell carcinoma of scalp and skin of neck Primary osteoarthritis involving multiple joints Endocrine/Metabolic Acquired hypothyroidism Type 2 diabetes mellitus without complication, without long-term current use of insulin (CMS/HCC) Gout Mixed hyperlipidemia Other Abnormal ICD sensing Biventricular ICD (implantable cardioverter-defibrillator) in place Body mass index (BMI) 24.0-24.9, adult Hx of completed stroke Adjustment disorder with depressed mood
Allergies: LatexHives / Urticaria Clopidogrel Warfarin DigoxinOther (document details in comments)
Diagnostic Lab Data: 08/02/21 2039 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/02/21 1147 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: cough, runny nose scratchy throat


VAERS ID: 1574474 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-09
Onset:2021-08-02
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

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

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

Write-up: Pt reporting fatigue, tingling and numbness in arms, hands, feet and pain in neck area.


VAERS ID: 1574491 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-12
Onset:2021-08-02
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / UNK LA / IM

Administered by: Private       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, papaya, tramadol, ester-C, valsartan-HCTZ
Current Illness:
Preexisting Conditions: HTN, vitamin D deficiency
Allergies: augmentin, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: dizziness for approx 2 weeks


VAERS ID: 1574604 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro Zyrtec Flonase Ezetimibe Saw Palmetto
Current Illness:
Preexisting Conditions: Anxiety High Cholesterol
Allergies: Clindamycin cephalexin
Diagnostic Lab Data: Doc checked my vitals and everything was fine
CDC Split Type:

Write-up: Dizziness Vertigo Nausea Ears feel full


VAERS ID: 1575616 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Dizziness, Fatigue, Insomnia, Nausea, Painful respiration, Tinnitus
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: Since 8/2/21, been dealing daily with extreme fatigue, lightheadedness, and dizziness. Every night hard time falling asleep and staying sleep, sleep is very scattered and never very long. Most days nausea and stomach pains. Ringing in the ears on some days. Today 8/16/21, new symptoms added: constant chest pain, pain taking a deep breath, and unable to complete a full deep breath. Have not sought medical attention yet, was given the info and link to come here and report my symptoms after completing daily check in today on website


VAERS ID: 1575626 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-08-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW981 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Birth control and acid reducer
Current Illness: None
Preexisting Conditions: None
Allergies: None that I know of
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was having chest pain a few days after the vaccine. It went on for days and then one day in the grocery store I started to feel dizzy. I had the chest pain and dizziness for about a week. The chest pain/ pressure is still there but luckily haven''t been getting dizzy anymore.


VAERS ID: 1577253 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-26
Onset:2021-08-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site nodule, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 1 week to the day of vaccination, a painful, hard bump at injection site appeared along with an itchy red rash. Rash started quarter sized and ended baseball sized in diameter. It lasted 2 weeks.


VAERS ID: 1577953 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-01
Onset:2021-08-02
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Dyspnoea, Pulmonary embolism, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes High blood pressure Liver Transplant patient
Allergies:
Diagnostic Lab Data: chest x-rays Covid-19 test
CDC Split Type: vsafe

Write-up: I have SOB and weakness. I have a fever. I went to the ER. I am on oxygen. They did a Covid-19 screen test, positive for Covid-19. I am currently hospitalized. They did chest X-ray, mild disturbing to lower bottom of the lungs. I was pulmonary embolism which has now cleared up.


VAERS ID: 1578159 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-25
Onset:2021-08-02
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Moderna on 2/25/21 and 4/1/21. Positive on 8/3 hospitalized 8/2 discharged 8/4


VAERS ID: 1578169 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-09
Onset:2021-08-02
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: hospitalized on 08/02/2021. still current pt as of 8/17 J&J 6/9. Stated in MD note. Positive on 8/3


VAERS ID: 1578180 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-23
Onset:2021-08-02
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler calcium citrate-vitamin D3 500 mg calcium -400 unit tablet,chewable calcium-vitamin D3-vitamin K 500-500-40 mg-unit-mcg tablet,chewable cefpodoxime (VANTIN) 200 mg tablet colestipol (COL
Current Illness:
Preexisting Conditions: Nervous Right lumbar radiculopathy Pronator syndrome, right Cubital tunnel syndrome on right Respiratory Intermittent asthma Chronic rhinitis Digestive Vitamin D deficiency Barrett''s esophagus without dysplasia Postgastrectomy malabsorption Diarrhea due to malabsorption Gastroesophageal reflux disease without esophagitis Chronic diarrhea Musculoskeletal Osteoarthritis of both knees Degenerative disc disease, lumbar Plantar fascial fibromatosis Hematologic Hypercoagulable state, secondary Other Other fatigue Pelvic floor weakness in female Strabismic amblyopia, left eye Medication management Status post biliopancreatic diversion with duodenal switch Abnormal LFTs (liver function tests) Difficulty speaking History of bariatric surgery
Allergies: Sulfa (Sulfonamide Antibiotics)Swelling Amoxicillin Amoxicillin-pot Clavulanate Grass Pollen-timothy, StandardOther (document details in comments) MoldOther (document details in comments) OtherOther (document details in comments) Pollen ExtractsOther (document details in comments)
Diagnostic Lab Data: 08/05/21 1038 POCT COVID-19 PCR Collected: 08/05/21 1037 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000275707 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 7/10/22
CDC Split Type:

Write-up: Dx Fatigue ? Acute bacterial sinusitis


VAERS ID: 1578217 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-11
Onset:2021-08-02
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Admitted 8/2-8/6 Moderna on 2/11/21 and 3/12/21. Positive on 8/3


VAERS ID: 1578226 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-07
Onset:2021-08-02
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Dementia, Exposure to SARS-CoV-2, Infusion, Oxygen saturation, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Dementia (narrow), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: cholecalciferol, vitamin D3, (VITAMIN D3 ORAL) coenzyme Q10 (CO Q10) 100 mg capsule donepeziL (ARICEPT) 10 mg tablet finasteride (PROSCAR) 5 mg tablet hydroCHLOROthiazide (HYDRODIURIL) 25 mg tablet memantine (NAMENDA) 10 mg tablet multiple
Current Illness:
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: 08/05/21 1443 POCT COVID-19 PCR Collected: 08/05/21 1442 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000272599 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 6/19/22
CDC Split Type:

Write-up: Exposure to COVID-19 virus / ASYMPTOMATIC COVID-19 virus infection Dx Medication Infusion Reason for Visit Progress Notes Encounter Date: 8/6/2021 ? ? Signed Patient is here for MAB Infusion O2 sats $g or = 90% Signs of potential reaction reviewed with patient. Pt wife who is also Covid pos stayed with pt due to his dementia Tolerated IV start and MAB infusion without complication. Pt has access to pulse oximeter and thermometer for home monitoring Discharge instructions reviewed. Patient denies any questions


VAERS ID: 1578266 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Dyspnoea, Headache, Magnetic resonance imaging head normal, Pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Blood tests, brain mri, ct scans. All came back normal.
CDC Split Type:

Write-up: I?ve had a hard time breathing since the Tuesday after. Developed a bad headache this week, and wake up with sharp head pains. I also have aches around my body.


VAERS ID: 1578500 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: After first dose MODERNA shot I feel my left pain . Doctor recommend take over counter ibuprofen but not help my chest go way yet .After 2 week still pain in my chest .


VAERS ID: 1578503 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-25
Onset:2021-08-02
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Rhinorrhoea, SARS-CoV-2 test, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler atorvastatin (LIPITOR) 80 mg tablet busPIRone (BUSPAR) 15 mg tablet calcium carbonate-vitamin D3 (CALCIUM 500 WITH D) 500 mg(1,250mg) -400 unit tabl
Current Illness:
Preexisting Conditions: Nervous Alcohol dependence (CMS/HCC) Other polyneuropathy Neurogenic claudication due to lumbar spinal stenosis Respiratory COPD, mild (CMS/HCC) OSA on CPAP Circulatory Atrial fibrillation (CMS/HCC) CAD (coronary artery disease) Hypertension Digestive Fatty liver Liver fibrosis Genitourinary Enlarged prostate without lower urinary tract symptoms (luts) Endocrine/Metabolic Prediabetes Other Insomnia, unspecified type Tremors of nervous system Anticoagulant long-term use Adenomatous polyp Imbalance Fall, subsequent encounter
Allergies: PenicillinsRash
Diagnostic Lab Data: 08/09/21 0055 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/08/21 1511 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/09/21 0055 COVID-19 PCR Collected: 08/08/21 1511 | Final result | Specimen: Swab from Nares
CDC Split Type:

Write-up: cough; mild headache, fatigue and sniffles


VAERS ID: 1578573 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-01
Onset:2021-08-02
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ACCU-CHEK AVIVA PLUS TEST STRP strip ACCU-CHEK FASTCLIX LANCET DRUM misc atorvastatin (LIPITOR) 40 mg tablet cholecalciferol, vitamin D3, 10 mcg (400 unit) capsule co-enzyme Q-10 50 mg capsule lysine 1,000 mg tablet metFORMIN (GLUCOPHAGE) 5
Current Illness:
Preexisting Conditions: Nervous Chronic pain of both knees Neuropathy Weakness of both legs Hearing loss Chronic bilateral low back pain without sciatica Circulatory Incomplete right bundle branch block (RBBB) Athscl heart disease of native coronary artery w/o ang pctrs Digestive Gastroesophageal reflux disease Obesity Genitourinary Benign papilloma of bladder Urolithiasis Frequent urination Difficulty in urination Musculoskeletal Arthritis Degeneration of lumbar or lumbosacral intervertebral disc Primary osteoarthritis of both knees Skin neoplasm Endocrine/Metabolic Mixed hyperlipidemia Type 2 diabetes mellitus without complication, without long-term current use of insulin (CMS/HCC) Infectious/Inflammatory Sarcoidosis Other Positive ANA (antinuclear antibody) Hx of colonic polyp
Allergies: NKA
Diagnostic Lab Data: 08/05/21 1148 POCT COVID-19 PCR Collected: 08/05/21 1147 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # m159923 Point of Care COVID-19 PCR Testing Method Abbott ID NOW Lot Expiration Date 11/14/21
CDC Split Type:

Write-up: COUGH, Fatigue, Muscle or body aches, Headaches and Congestion or runny nose


VAERS ID: 1578625 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW8172 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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: Iron, vitamin c
Current Illness: None
Preexisting Conditions: None
Allergies: Erythromicin, vicodin, aspirin, neomycin, reglan, darvocet, demoral,
Diagnostic Lab Data: EKG done at doctors office on the 3rd day.
CDC Split Type:

Write-up: Heart palpitations and racing for 3 days.


VAERS ID: 1578728 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-03-11
Onset:2021-08-02
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Glaucoma, Hypersensitivity, Intraocular pressure test, Ophthalmological examination, Rash, Visual field tests
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Glaucoma (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: Eye exam and have seen both and optometrist and ophthalmologist. . Both performed visual field tests, eye pressure and otc tests.
CDC Split Type:

Write-up: Originally reported to cdc. Severe allergic reaction second vaccine . Rash head to toe requiring steroid shots and prednisone. This month diagnosed with glaucoma. My doctor advised I report as it?s a known side effect the vaccine can stimulate glaucoma . Advised to not take any additional vaccines for Covid.


VAERS ID: 1578750 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-14
Onset:2021-08-02
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Work       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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT ONSET OF COVID SYMTOMS WAS 8/2/21, AND TESTED POSITIVE TO COVID ON 8/11/21


VAERS ID: 1578949 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-26
Onset:2021-08-02
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 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? 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: SARS COV2 - POSITIVE
CDC Split Type:

Write-up: SARS COV2 BY - POSITIVE


VAERS ID: 1578953 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-28
Onset:2021-08-02
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Work       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:
CDC Split Type:

Write-up: PATIENT HAS RECEIVED BOTH PFIZER COVID-19 VACCINE, TESTED POSITIVE TO COVID-19 8/11/21, AND ONSET OF SYMPOMS ON 8/2/21


VAERS ID: 1582144 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol 2 mg qHS: vitamin c, vitamin D3; zinc, selenium, magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: Allergies to sulfa drugs, phisohex
Diagnostic Lab Data: None, watch and wait to see how 2nd dose affects the area
CDC Split Type:

Write-up: 1st vaccine 7-27-21, left upper arm. On 8-2-21 noticed lump/swollen lymph node on left upper clavicle base of neck, increasingly tender thru day. 8-3-21 diffuse swelling from upper clavicle down to upper left breast, rash/broken blood vessels between clavicle and shoulder, extreme tenderness of all areas but primarily at the supraclavicular lump/lymph node. As of 8-18-21 the lump/swollen supraclavicular lymph node has remained however tenderness and swelling, rash has subsided/resolved


VAERS ID: 1582302 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-07
Onset:2021-08-02
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Exposure to SARS-CoV-2, Pyrexia, SARS-CoV-2 test, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (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: calcium carbonate-vitamin D3 1250 mg, 500 mg calcium,-5 mcg 1250 mg (500 mg calcium)-200 unit per tablet empagliflozin (JARDIANCE) 10 mg tablet tablet glimepiride (AMARYL) 4 mg tablet metFORMIN (GLUCOPHAGE) 1,000 mg tablet pravastatin (PRAV
Current Illness:
Preexisting Conditions: Digestive Morbid obesity Endocrine/Metabolic Type 2 diabetes mellitus Other History of pulmonary embolism History of DVT (deep vein thrombosis) Depressive disorder
Allergies: Adhes. Band-tape-benzalkonium Tetanus Vaccines And Toxoid
Diagnostic Lab Data: 08/03/21 0844 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/02/21 1821 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/03/21 0844 COVID-19 PCR Collected: 08/02/21 1821 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Exposure to SARS-associated coronavirus Fever, unspecified fever cause Loss of smell Loss of taste Progress Notes Signed Encounter Date: 8/6/2021 Signed Hide copied text Hover for details Patient here for Regeneron infusion. Patient tolerated infusion well and was monitored for 1 hour post. Upon discharge, patient was provided a pulse ox, thermometer, after visit summary and follow up instructions. No adverse events noted during this visit.


VAERS ID: 1582605 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Incomplete course of vaccination
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: influenzas 2 times and ended up having sever colitis twice
Other Medications: Tylenol with Hydrocodone; Vitamins; Motrin; Vicodin.
Current Illness: Very healthy
Preexisting Conditions: Nothing pertinent to this
Allergies: No
Diagnostic Lab Data: Scheduled for a CAT scan next.
CDC Split Type: vsafe

Write-up: Received vaccine within 5-10 minutes shortness of breath, tightness of chest, labored breathing. Primarily in the diaphragm area. Chest wall symptoms bilaterally. Currently still getting worked up for that. Physician put me on a prednisone taper to reduce inflammation. I was evaluated yesterday and they said with everything taken into account and if my chest wall improves to my comfort level she will have me get a CAT scan of the chest next week. I have not ever in my life had chest wall stiffness like this. I was advised due to the circumstances do not get the 2nd dose.


VAERS ID: 1582805 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-23
Onset:2021-08-02
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Echocardiogram, Electrocardiogram abnormal, Palpitations, Ventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PVC observed in EKG on 8/13. pending further results from Heart Echo and Ultrasound scheduled but not completed yet
CDC Split Type:

Write-up: Heart fluttering / palpitations starting about 10 days after the shot


VAERS ID: 1582840 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Hallucination, Heavy menstrual bleeding, Narcolepsy, Sleep paralysis, Sleep terror, Somnolence
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armodafinil 250mg Bupropion 150mg Zyrtec
Current Illness: None
Preexisting Conditions: Type 1 Narcolepsy (with Cataplexy), Endometriosis
Allergies: Macrobid Morphine Thiuram Mix Gluten Dairy Eggs Gold
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 1. Extreme worsening of Narcolepsy symptoms - severely fatigued, excessive day-time sleepiness, very frequent cataplexy, hallucinations, night terrors, sleep paralysis 2. Breakthrough blood clots between menstrual cycle


VAERS ID: 1582886 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-16
Onset:2021-08-02
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Cough, Headache, Oropharyngeal pain, Polymerase chain reaction positive, Rhinorrhoea, Sinusitis
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hashimoto''s, thyroid, arthritis , osteoporosis, barret''s esophagus
Allergies:
Diagnostic Lab Data: PCR collected 8-2-2021, resulted positive on 8-3-2021
CDC Split Type:

Write-up: Runny nose, sore throat, cough, chest pain, headache, sinusitis


VAERS ID: 1582919 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-01
Onset:2021-08-02
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Alanine aminotransferase increased, Amylase, Aspartate aminotransferase increased, Blood fibrinogen, Blood thromboplastin decreased, Brain natriuretic peptide normal, C-reactive protein increased, Cough, Fibrin D dimer increased, Haemoglobin normal, Hepatic enzyme increased, Immunoglobulin therapy, Leukopenia, Lipase increased, Lymphocyte count decreased, Lymphopenia, Neutrophil count decreased, Pancreatitis, Platelet count normal, Pyrexia, Respiratory distress, Rubulavirus test positive, SARS-CoV-2 antibody test, SARS-CoV-2 antibody test negative, Serum ferritin increased, Tachycardia, Troponin normal, White blood cell count decreased
SMQs:, Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ferrous sulfate, loperamide, metoclopramide, Botox (IM), famotidine, budesonide, albuterol, lactobacillus, aspirin, diazepam, baclofen (oral), gabapentin, phenobarbital
Current Illness:
Preexisting Conditions: Global developmental delay, restrictive lung disease, scoliosis, seizure disorder
Allergies: NKDA
Diagnostic Lab Data: AST 209, ALT 133, lipase 3480, amylase 432 Ferritin 900, fibrinogen 371 BNP <10, troponin <0.012 WBC 1.5 (ANC 300, ALC 850), Hgb 13.8, platelets 179 D-dimer 1.4, aPTT 32.2, PT 14.2 CRP 31 -- $g 162 SARS-CoV-2 spike antibodies 921, SARS-CoV-2 nucleocapsid antibodies Negative Parainfluenza virus 2 PCR Positive
CDC Split Type:

Write-up: Fever with cough, respiratory distress, tachycardia, leukopenia, lymphopenia, elevated liver enzymes, and pancreatitis; IV hydration, IVIG, ASA, prednisolone


VAERS ID: 1582998 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-03
Onset:2021-08-02
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ACCU-CHEK AVIVA PLUS TEST STRP strip ACCU-CHEK FASTCLIX LANCET DRUM misc atorvastatin (LIPITOR) 40 mg tablet cholecalciferol, vitamin D3, 10 mcg (400 unit) capsule co-enzyme Q-10 50 mg capsule lysine 1,000 mg tablet metFORMIN (GLUCOPHAGE) 5
Current Illness:
Preexisting Conditions: Nervous Chronic pain of both knees Neuropathy Weakness of both legs Hearing loss Chronic bilateral low back pain without sciatica Circulatory Incomplete right bundle branch block (RBBB) Athscl heart disease of native coronary artery w/o ang pctrs Digestive Gastroesophageal reflux disease Obesity Genitourinary Benign papilloma of bladder Urolithiasis Frequent urination Difficulty in urination Musculoskeletal Arthritis Degeneration of lumbar or lumbosacral intervertebral disc Primary osteoarthritis of both knees Skin neoplasm Endocrine/Metabolic Mixed hyperlipidemia Type 2 diabetes mellitus without complication, without long-term current use of insulin (CMS/HCC) Infectious/Inflammatory Sarcoidosis Other Positive ANA (antinuclear antibody) Hx of colonic polyp
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough Fatigue Muscle or body aches Headaches Congestion or runny nose


VAERS ID: 1583127 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-17
Onset:2021-08-02
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

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: Tresiba, Novalog
Current Illness:
Preexisting Conditions: Diabetes Type 1
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus


VAERS ID: 1583129 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-08-02
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: norethindrone-e.estradioL-iron (JUNEL FE 1/20, 28,) 1 mg-20 mcg (21)/75 mg (7) per tablet
Current Illness:
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: 08/07/21 1248 POCT COVID-19 PCR Collected: 08/07/21 1248 | Final result | Specimen: Swab POC COVID-19 PCR DetectedAbnormal Lot # 1000271388 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 6/19/2022
CDC Split Type:

Write-up: sore throat and cough.


VAERS ID: 1583149 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-16
Onset:2021-08-02
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Headache, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test, Sensory loss
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Digestive Obesity
Allergies: NKA
Diagnostic Lab Data: 08/03/21 0038 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/02/21 1953 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/03/21 0038 COVID-19 PCR Collected: 08/02/21 1953 | Final result | Specimen: Swab from Nares
CDC Split Type:

Write-up: Dx Nasal Congestion ? Sore Throat ? loss of senses ? Shortness of Breath ? Cough ? Headache


VAERS ID: 1586941 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Discomfort, Electrocardiogram abnormal, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: An hour after my shot I felt chest pressure. It was very uncomfortable. It resolved itself within 5 hours. I went to my PCP to check it out a week later. He said my EKG reported pericarditis. I am going to see a cardiologist this week.


VAERS ID: 1587373 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Electrocardiogram, Hypoaesthesia, Pain, Throat tightness, Ultrasound Doppler, Urine analysis, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantoprazole, Mucinex, Multivitamin, Fiber Pills, and Claritin.
Current Illness: None
Preexisting Conditions: GERD
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had complete numbness in legs and hands at times. I started showing a reaction the day after the shot. It started on Monday and included numbness in my right foot and shin. I also had welts on my back and arms. I went the the ER because my primary doctor at the time was unable to see me. They instructed me to go to the ER. I also had tightening in my throat and chest on Monday. The ER did blood work, uranalysis, and EKG. All checked out fine. They told me if the numbness and pain went above my shines to come back. They felt it was a reaction to the shot. I continued to have the numbness Tuesday and went to work. During my shift, the pain increased greatly and the numbness traveled up my legs to above my knee. I also was getting random pains and numbness in my fingers and sometimes my whole hand. I returned to the ER that night. They did an ultrasound and blood work and it showed no signs of a blood clot. They sent me home and again stated it must be a reaction to the shot. I continued to get numbness for days afterwards. It finally seemed to ease up after 14 days. I was advised by my primary care doctor not to receive the 2nd dose due to my adverse reaction.


VAERS ID: 1589058 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Breast pain, Breast swelling, Breast tenderness, Pain
SMQs:, Angioedema (broad), Lipodystrophy (broad)

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

Write-up: My breasts grew bigger by another size and I experience painful swelling in both breasts, even though its been more than 3 weeks from the vaccination date. It started approximately 4-5 days after the first shot. I experienced sharp burning pain in my right breast. A couple of days after, the burning pain decreased, but by that time both breasts grew in size, became swollen, and painful to touch. Today I was supposed to take my second shot, but my breasts still hurt, and I decided to wait until swelling will go away. I couldn''t find any additional information or recommendations on what to do if these symptoms are not gone 10-14 days after the vaccine and this is very frustrating


VAERS ID: 1589071 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-08-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fear, Injection site pain, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol
Current Illness:
Preexisting Conditions: cardiomyopathy
Allergies: none
Diagnostic Lab Data: none yeet.. i?m making an appointment to see my primary doctor.
CDC Split Type:

Write-up: continued pain on location of injection and then i take a look at my arm and my skin is peeled around the area and i have been monitoring the area to see if the peeling isn?t spreading and it is. my main concern is it doesn?t continue to peel more of my skin.. it?s ugly yo look at and now it?s consuming e with fear of losing more skin.


VAERS ID: 1591225 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Unknown       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 medication
Current Illness:
Preexisting Conditions: Hypothyroidism managed with Synthroid medication
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Tinnitus Recurrent


VAERS ID: 1591676 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-29
Onset:2021-08-02
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Bell's palsy, Blood test normal, Ear pain, Facial paralysis, Headache, Heart rate irregular, Muscle tightness, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiac arrhythmia terms, nonspecific (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting in spring of 2021 I noticed I would have an irregular heart rate when running, something I had not experienced prior. I also started having severe abdominal pain to the point I went to my PCP to inquire. It was not stated what the cause of this was, blood work was done everything looked OK and ultrasound was offered. I declined as I knew I would be told ?I don?t know what it is.? Sunday, August 1, 2021 I went to bed with ear pain in my right ear, a headache and a tightness in my neck. I woke up Monday, August 2, 2021 to the right side of my face being paralyzed. After going to the ER that day they diagnosed me with Bell?s palsy. Monday will be three weeks I have had it. I?m experiencing constant dizziness, nausea, pain in my ear & neck.


VAERS ID: 1591792 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-26
Onset:2021-08-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / UNK RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chest discomfort, Hyperaesthesia, Swelling, Tenderness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Received vaccine 07/26/2021 Right arm . The next day my upper right side of Chest felt almost swollen/ stiff, no physical pain. On roughly 08/02/2021, I noticed that the feeling of my upper right side of chest felt almost swollen/stiff again, but this time, above my collarbone the area was sensitive to the touch. In addition, upon feeling around the area, I noticed a small bump were my vein/ tendon is. I researched and found that others experienced similar cases with the Pfizer shot. I did not seek medical attention as the tenderness and swollen feeling went away after about 5 days. I have received my second dose today, 8/20/2021 and was told to report my Adverse reaction to the first dose.


VAERS ID: 1591864 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-04
Onset:2021-08-02
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 - / -

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

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

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


VAERS ID: 1593223 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dyspnoea, Eye discharge, Fatigue, Headache, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: Montelukast
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Sulfa, latex, nickel
Diagnostic Lab Data: None. Did not seek medical treatment. Used tylenol, Ibuprofen, sudafed, allegra, albuterol inhaler, and drank fluids
CDC Split Type:

Write-up: Fever, extreme fatigue, chills, shortness of breath, diarrhea, congestion, runny eyes, headache x 1 week


VAERS ID: 1602934 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-04-08
Onset:2021-08-02
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Inflammation
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: Right finger inflammation for no reason


VAERS ID: 1602962 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Polymenorrhoea
SMQs:

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

Write-up: Periods within 2 weeks of each other Fatigue


VAERS ID: 1617449 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-24
Onset:2021-08-02
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Oxygen saturation decreased, Pneumonia, Respiratory failure, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 MG PO Tablet Take 3 tablets by mouth every 6 hours for 14 days. 10/24/19 11/7/19 amoxicillin-clavulanate (AUGMENTIN) 875-125 MG Oral Tablet Take 1 tablet by mouth every 12 hours for 10 doses. 7/30/21 8/4/21
Current Illness:
Preexisting Conditions: ? Hyperlipidemia ? Hypertension ? Malignant neoplasm of sigmoid colon (CMS-HCC: 11) 10/3/2019 ? Multiple myeloma
Allergies: NKDA
Diagnostic Lab Data: SARS-COV-2, NAA, Detected: 07/28/21.
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (third dose in series) on 02/24/21. Hospitalized from 08/02/21 - 08/13/21. Below is copied from discharge summary: a 79 y.o. female pertinent PMHx of HTN, CKD Stage G1, sigmoidal colon cancer status post colostomy in 2019 with chemoradiation subsequent year, currently on 5-FU and Avastin, multiple myeloma on Revlimid, VTE (Dec 2020) on apixaban who presented on 8/2/21 with hypoxemic respiratory failure. Required HFNC in ED to maintain oxygen saturations. Patient treated for HAP. Initially covered with pip-tazo and transitioned to levofloxacin (completed 8/7). Needs STR. Patient desaturated with PT/OT and thus will require home oxygen at discharge.


VAERS ID: 1617526 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-08-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Arthritis, Bone disorder
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Systemic: developed arthritis in arm that was injected-Medium, Systemic: Joint Pain-Medium, Additional Details: in addition to arthritis, an enlargement and protrusion of what seems to to be bone in elbow of injected arm has occurred


VAERS ID: 1617598 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dizziness, Fatigue, Fear, Feeling abnormal, Gastrointestinal disorder, Groin pain, Hyperhidrosis, Nausea, Night sweats, Pain, Pain in extremity, Panic reaction, Presyncope, Testicular pain, Tinnitus
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 50mg, Omeprazole 20mg
Current Illness:
Preexisting Conditions: GERD, Anxiety, Restless Legs Syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approx. 17 hours after receiving 2nd dose (around 4am on 8/2/21): woke up with stomach/gastro issue, and then sudden onset of intense dizziness, nausea and light-headedness (near-syncope?), ringing in ears, sweating, intense feeling of panic/terror/impending doom, vibrational/buzzing felt throughout entire body. Duration - maybe 5-10 minutes Continued / ongoing effects have been strange intermittent pains throughout body and soreness. In particular lower legs, sometimes felt through my groin / testicular area, fatigue, and night sweats


VAERS ID: 1622030 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-01
Onset:2021-08-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Influenza like illness, Lymphadenopathy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (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: Sprintec, 75 mg spironolactane, buspar 10 mg, Wellbutrin 150 mg, vitamin d3
Current Illness:
Preexisting Conditions: Eczema
Allergies: Penicillin, tetracycline, mild dairy allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flu like symptoms- fever, chills, body ache, fatigue lasted about 20 hours, pain in left shoulder, swollen lymph nodes in left armpit for 3-4 days. Intense headache followed for 5 days after flu like symptoms eased up.


VAERS ID: 1623064 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-31
Onset:2021-08-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Fatigue, Flushing, Head discomfort, Hyperhidrosis, Hypertension, Loss of consciousness, Pallor, Palpitations, Paraesthesia, Peripheral coldness, Tachycardia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (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: Corlanor Alprazolam Albuterol
Current Illness: None
Preexisting Conditions: Asthma, POTS, Ehlers Danlos Type 3
Allergies: Peanuts and tree nuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Passing out, heart flip flops, tachycardia, high blood pressure, excessive sweats, tingling and cold in hands and feet, chest pain, dizziness, weird scary head pressure, flushing and then extreme paleness, exhaustion


VAERS ID: 1623377 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-07-27
Onset:2021-08-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Laboratory test
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CHEST XRAY - LAB TEST , WALL CHEST PAIN
CDC Split Type:

Write-up: CHEST PAIN


VAERS ID: 1623484 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Diplopia, Facial pain, Neuralgia, Tolosa-Hunt syndrome
SMQs:, Peripheral neuropathy (narrow), Glaucoma (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Patient had flare of her Tolosa Hunt Syndrome. She had nerve pain on the left side of face since yesterday. Aggravated with double vision


VAERS ID: 1623591 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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: Multivitamins -.vitamin D- c- zinc
Current Illness:
Preexisting Conditions: Granuloma annulare - ibs
Allergies: Penicillin - dairy & gluten intolerance
Diagnostic Lab Data:
CDC Split Type:

Write-up: Constant tinnitus - every day all day


VAERS ID: 1623936 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mass, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: left side tingling. nose swollen and a lump appeared.


VAERS ID: 1623974 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-15
Onset:2021-08-02
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 2 AR / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: COVID-19 TEST- POSITIVE
CDC Split Type: vsafe

Write-up: 08/01/2021 I was in my household. There was 2 people in my household who tested positive. 1 was an adult who was fully vaccinated. the other was a child who was not vaccinated. I tested positive 08/02/2021, and I quarantined for 10 day. On 08/002 I lost my sense of smell. I saw my doctor virtually. She gave me medication for severe allergies for 6 day. My symptoms went away in like 2 or 3 day after I started the medication. I was tired and lost me sense of smell. My sense of smell is not fully back. I smell only really strong odors.


VAERS ID: 1624041 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-02
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / IM

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

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

Write-up: patient developed hives 4 hours after vaccination, started taking antihistamines every 4 hours to manage symptoms, came to clinic on 8/22/21 and got dexamethasone 8mg IM, called on 8/23/21 that symptoms were returning, was prescribed prednisone taper pack.


VAERS ID: 1624077 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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


VAERS ID: 1624120 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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


VAERS ID: 1624216 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

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


VAERS ID: 1624308 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-07-26
Onset:2021-08-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up and had a rash on her torso, arms and legs and about an hour later developed into hives. That night she got appendicitis and was admitted into the hospital for surgery. She had not been sick nor eaten anything different, nor taken any medications. The only thing different was the 2nd covid vaccine given the week before. She had no issues with the first dose of the covid vaccine. I had to give her Benadryl for 5 days to keep the allergy under control. After 5 days it went away. I don?t know if the appendicitis was coincidental or related to the vaccine either. She had no symptoms prior to the evening of Aug 2nd when the pain began.


VAERS ID: 1625908 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Pruritus, 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: Albuterol, Aleve (otc)
Current Illness: N/A
Preexisting Conditions: Chronic Asthma
Allergies: N/a to products, seasonal allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe itching all over body & when scratched causing red marks & hives. The itching started approximately an hour & a half after getting the shot


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