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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 302 out of 7,116

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VAERS ID: 1522964 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-08-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Lymph node pain, Lymphadenopathy, Myalgia, Neck pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: mild fever, headache and muscle aches on day 2; ipsilateral adenopathy on day 3 and pain in the neck, possible also due to lymph node reactivity, which lasted about 24 hours; painful pulpable contralateral axillary lymph nodes that already lasted 2 days without any signs of improvement


VAERS ID: 1522983 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Blood test normal, Chills, Deafness, Disorientation, Dizziness, Electrocardiogram normal, Fall, Feeling abnormal, Feeling cold, Headache, Mydriasis, Pallor, Pyrexia, Sleep disorder, Syncope, Tremor, Vision blurred, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Children''s Zyrtec - 1xday/10ML
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: EKG - normal; Blood work - normal
CDC Split Type: vsafe

Write-up: She came to my bed side at 2:30AM and told us that she was feeling cold. I took her to the bathroom and told her that I would go downstairs to get her medicine cup. I heard a loud crash upstairs. She had fallen. I handed her the Tylenol and she was so disoriented that she dropped the medicine all over the floor. She said her eyes felt fuzzy and she couldn''t hear. She turned completely pale white and her pupils were very dilated. She was ice cold. I called 911. My husband tried to keep her talking and she said her vision was very fuzzy. She completely fainted and was shaking for about 10 minutes. The ambulance took her to the ER (UTMC Hammock) and did an IV. They took lots of blood for blood work. The doctor ran an EKG. When the doctor had her stand up, she started getting fuzzy eyes and dizziness. Then she vomited. They gave her some Zofran. The EKG came back normal. All of her blood work came back normal. They let her have the whole bag of IV fluids. We got home around 7AM. She''s up to date on all her vaccinations and never had a reaction before. Today is her first day feeling back to normal. She did have chills, a headache, a slight fever, and her arm pit was sore. She had a follow up appointment yesterday at 11AM. When we saw her doctor yesterday, there were 3 viles of blood that came back kind of iffy. She is going to check to see if those are normal and let us know.


VAERS ID: 1523000 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Asthenia, Cardiac flutter, Chills, Decreased appetite, Fatigue, Feeling abnormal, Injection site erythema, Injection site pruritus, Injection site swelling, Mobility decreased, Night sweats, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tachyarrhythmia terms, nonspecific (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: I was fatigued the evening following my vaccine. A little over 12 hours following the vaccine timing I woke up with severe arm pain to where I could barely lift my arm. A couple hours later I developed pain in every joint in my body. Chills. Fever. Exhaustion. No appetite. I finally took ibuprofen 24 hours following the time of vaccine and my fever broke and joint pain eased. Had night sweats the following night. 3 days post vaccine my arm swelled up at site of injection, was red and itchy. Still no appetite on the 3rd day. Currently it''s day 4 and redness has subsided at injection site but itching and swelling still persists along with no appetite, brain fog, low energy, and minor anxiety due to heart flutters.


VAERS ID: 1523011 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-03
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

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

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

Write-up: Patient received 0.3 mL of undiluted Pfizer COVID-19 injection rather than 0.3 mL of diluted vaccine.


VAERS ID: 1523061 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-18
Onset:2021-08-01
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory distress syndrome, COVID-19, Cardio-respiratory arrest, Chest X-ray abnormal, Endotracheal intubation, Intensive care, Lung opacity, SARS-CoV-2 test positive, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (narrow), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), 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? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: pepcid, isosorbide mononitrate, allopurinol, entresto, coreg, insulin, lasix, glipizide, lipitor, metformin
Current Illness: NA
Preexisting Conditions: CAD s/p CABG, HTN, CHF, OSA, DM2, obesity, gout
Allergies: lisinopril, shrimp
Diagnostic Lab Data: Covid PCR+ on 8/1, CXR showed bilateral opacities.
CDC Split Type:

Write-up: Patient recieved 2 doses of pfizer 2/18/21 and 3/11/21. Then developed covid ARDS requiring hospitalization. Also troponin elevation, AKI. Intubated in ICU curently. Had code blue during intubation, but appears to have stabilized for the time being.


VAERS ID: 1523090 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Seizure, Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Medium, Systemic: Seizure-Mild, Systemic: Vomiting-Mild, Systemic: Weakness-Mild


VAERS ID: 1523102 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-24
Onset:2021-08-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid vax 1st dose swelling at injection site, lightheadedness
Other Medications: arthritis medication, vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Penecilin, aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: "On and off" scratchy throat


VAERS ID: 1523144 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: No not to date.
CDC Split Type:

Write-up: 1.Small rash on axial line, one severely itchy wheal 2. Insomnia started the night of vaccine but appears to be improving . 3.Pain at injection site continues today but has started to wane as of today.


VAERS ID: 1523150 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Wrong 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: No know allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came in looking to receive a meningitis shot. The technician administering the vaccine failed to communicate and confirm with the patient which vaccine they were receiving and they ended up getting a COVID shot when they were supposed to receive the meningitis shot. After the injection, the patient stated they had completed the Pfizer 2-dose series back in June at another pharmacy, so this was the third COVID dose they had received. We contacted Pfizer for guidance and there was no information/recommendations currently out for patients who inadvertently received a third dose. They advised the patient to monitor for any adverse reaction and to follow up with their healthcare provider as needed.


VAERS ID: 1523160 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-23
Onset:2021-08-01
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site rash, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

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

Write-up: Redness/rash at injection site, tender and warm to touch


VAERS ID: 1523304 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Gave patient his shot, told him to stick around for 15 minutes, after about 5 minutes he came up to the counter very pale and sweating, I brought him into the consultation room to sit down and gave him water. After about 20 minutes he was okay to leave, he walked here so I asked him to get someone to pick him up, his mom came to pick him up. I tried to call later that day to check on him but no answer


VAERS ID: 1523390 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Lymph node pain, Lymphadenopathy, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: Cold a week prior
Preexisting Conditions: High blood sugar no medcations
Allergies: Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Horrible pain swelling of lymph nodes on left armpit not alleviated by tylenol moritrin, itchy left arm, fever over 101 for 48 hrs, armpit pain still continuing.


VAERS ID: 1523411 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 101.7 on Aug 2 at 6 pm Chest pain began around the same time and is persistent even today Aug 3rd at 6 pm


VAERS ID: 1523429 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: unknown
Preexisting Conditions: diabetes
Allergies: none
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Patient reports that the next morning after receiving his second dose his legs and feet were swollen. This condition has worsened over the last 2 days and I advised him to contact his PCP. His right calf is extremely swollen and both feet as well.


VAERS ID: 1523430 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Penicillin, sulfa, tomato
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swelling, redness, discomfort, and warmth to the touch


VAERS ID: 1523447 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tongue geographic
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ibuprofen 800 vitamin vitamin C Lipitor 6mg baclofen, tramadol Zyrtec
Current Illness: UTI
Preexisting Conditions: asthma high cholesterol
Allergies: neriolin Shell fish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Geographical Tongue


VAERS ID: 1523466 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Arthralgia, Back pain, Chest pain, Diarrhoea, Dizziness, Dysstasia, Mobility decreased, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women 1 a day gummy vitamins
Current Illness: None
Preexisting Conditions: None sinus headaches and prior major surgeries
Allergies: None
Diagnostic Lab Data: My Doctor can?t see me until tomorrow at 10:45am
CDC Split Type:

Write-up: On Sunday evening started having severe stomach pain burning sensation from abdomen to my upper chest, uncontrollable throwing up and diarrhea and pains in my back shoulder blade area as well as lightheadedness to the point of feeling faint . Was Unable to stand or sit with out extreme burning in the same areas listed above. Today the burning , back pain, and diarrhea still exist but throwing up stopped yesterday after taking pepto , the diarrhea isn?t as intense but is still here . Back pain is still here and can?t move or lay or my side or stomach due to the burning in my lower abdomen as it longer goes up to my chest .


VAERS ID: 1523478 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Hyperhidrosis, Migraine, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Dizziness Fever Full body shakes Chills Exhaustion Migraine Sweats


VAERS ID: 1523481 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-20
Onset:2021-08-01
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blindness, Cerebrovascular accident, Diagnostic aspiration, Injury, Retinal artery occlusion
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Accidents and injuries (narrow), Hostility/aggression (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 137 mcg, Sertraline 50mg
Current Illness: None
Preexisting Conditions: Hypothyroidism, mild depression
Allergies: None
Diagnostic Lab Data: Went to ER on 8/1 with vision loss. Had CT angio scan, several radiograph injection tests that looked at blood flow to eye and found ?retinal artery occlusion?. They couldn?t believe I had this because I was so young and perfectly healthy. All follow-up tests to determine a cause came up negative. They do not know why this happened to me and I wondered if it had anything to do with the vaccine. My vision loss is permanent. :(
CDC Split Type:

Write-up: I had an eye stroke and lost 50% vision in my right eye


VAERS ID: 1523485 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-21
Onset:2021-08-01
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

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

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

Write-up: About a week later an itchy rash appeared on my arm at injection site. In addition, the soles of my feet became itchy along with a few minor spots on either both hands. All reminiscent of bug bites. By far the biggest cluster was around the place of injection.


VAERS ID: 1523668 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-02
Onset:2021-08-01
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: HA and Nausea.


VAERS ID: 1523690 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-08-01
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad)

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

Write-up: cough, congestion


VAERS ID: 1523879 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-28
Onset:2021-08-01
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blindness, 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), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flonase, nasal spray, 325 mg aspirin, 1200 mg Gabapentin, Roturvastatin, Topiramate 100 mg, Levothyroxine .80mg. Sertraline 100mg, Ezetimibe 10mg
Current Illness: None
Preexisting Conditions: Clotting issues, prior stroke, above-knee amputation (left leg)
Allergies: Bees, Latex, amoxicillin, penicillin, erythromycin,
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had a stroke within 3 days of having the 2nd injection that caused loss of half of my eyesight in both of my eyes on the left side only.


VAERS ID: 1523908 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Injection site pain, Memory impairment, Retching
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 103 temp for the first 30 hours. Dry heaving for 1 hour (12 hours after shot). 0 energy; stayed in bed first 48 hours. Don''t remember much about past 2 days. Injection site sore.


VAERS ID: 1524124 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / UN

Administered by: Military       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram head, Facial paralysis, Headache, Magnetic resonance imaging head
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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone Junel FE Fluoxetine Vitamins B,D, C Methylphenidate
Current Illness: Infection from a pet rabbit scratch
Preexisting Conditions: Anxiety, depression, PTSD.
Allergies: N/A
Diagnostic Lab Data: MRI, CT Scan, Blood work on 8/2/21
CDC Split Type:

Write-up: 2 days later, severe headache, 3 days later lip drooping, 4 days later diagnosed with Bell''s Palsy.


VAERS ID: 1524125 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Hypotension, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: PATIENT CAME TO THE PHARMACY WITH HIS DAD. THEY CLAIMED HE IS ALLERGIC TO NUTS. WHEN I APPROACHED TO PROVIDE THE SHOT HE SAYS HE IS VERY SCARED ABOUT NEEDLES. I EXPLAINED THAT IT WON''T HURT AND IT WILL TAKE LESS THAN A SECOND. JUST AFTER I PROVIDED THE SHOT THE PATIENT PASSED OUT, TURNED VERY WHITE. I ASKED MY INTERN TO CALL ED AND WITH THE HELP OF HIS FATHER WE PUT HIM ON THE FLOOR AND IN ABOUT 15 TO 20 SECONDS HE STARTED RECOVERING. HE ASKED WHAT HAPPENED BUT THEN HE STARTED TO ANSWERING QUESTIONS PROPERLY. I TOOK THE BLOOD PRESSURE AND IT WAS VERY LOW ABOUT 85/75. JUST AFTER FINISHING ARRIVED THE RESCUE. AFTER 20 MINUTES WITH HIM THE BP KEPT VERY LOW AND THEY DECIDED TO TAKE IT TO THE HOSPITAL.


VAERS ID: 1524338 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

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

Write-up: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi-dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. Called the morning of 8/3/21 and spoke to the medical team at Pfizer who gave the same information. She was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline.


VAERS ID: 1524343 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: none
CDC Split Type:

Write-up: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi-dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. Client called the morning of 8/3/21 and spoke to Representative on the medical team who gave the same information. Representative was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline.


VAERS ID: 1524349 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-01
Onset:2021-08-01
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, COVID-19, Dysuria, Headache, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre 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? 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: NKDA
Diagnostic Lab Data: 7/31: Tmax 100.0 8/3: 2-3L O2
CDC Split Type:

Write-up: Patient fully vaccinated with Moderna (patient reports received 2nd dose 1/2021) contracts COVID, requiring admission to the hospital on 8/1/2021 (symptoms began 7/28). Chief complaint included weakness, headache, urinary symptoms, malaise. Required 2-3L O2 (no baseline oxygen requirements) - reported on hospital day 3. Patient treated with dexamethasone 4 mg. Required at least 4 days of hospitalization (reported hospital day 3).


VAERS ID: 1524350 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi-dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were n
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi-dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. Called the morning of 8/3/21 and spoke to the medical team at Pfizer who gave the same information. Was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline.


VAERS ID: 1524354 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: none
CDC Split Type:

Write-up: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi-dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store level, they were not able to give any information on anything other than the single-use vials that were studied. Called the morning of 8/3/21 and on the medical team at Pfizer who gave the same information. She was able to say that the reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials that were used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline.


VAERS ID: 1524357 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: None
CDC Split Type:

Write-up: Pfizer COVID vaccine incorrectly diluted with 0.9% normal saline in multi-dose vial with preservative. Correct diluent should be 0.9% normal saline in single-dose vial without preservative. When Pfizer was called at store-level, they were not able to give any information on anything other than the single-use vials were studied. Called the morning of 8/3/21 and spoke to the medical team at Pfizer who gave the same information. The reason Pfizer wants medical providers to use the single-use vials is so that there is no cross contamination from puncturing the vial multiple times to dilute multiple vaccine vials. The multi-dose vials used were only punctured once so no risk of contamination. Considering this a valid dose still since the vaccine was still diluted and administered with normal saline.


VAERS ID: 1524358 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

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

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


VAERS ID: 1524818 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Malaise, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210801; Test Name: Fever; Result Unstructured Data: 102.4 (unit not reported)
CDC Split Type: USJNJFOC20210802825

Write-up: TERRIBLE PAIN; FEEL ROTTEN/SICK; NAUSEA; FEVER; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 31-JUL-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 01-AUG-2021, the subject experienced terrible pain. On 01-AUG-2021, the subject experienced feel rotten/sick. On 01-AUG-2021, the subject experienced nausea. On 01-AUG-2021, the subject experienced fever. Laboratory data included: Fever (NR: not provided) 102.4 (unit not reported). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from nausea, terrible pain, fever, and feel rotten/sick. This report was non-serious.


VAERS ID: 1525344 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None, but I did experience a miscarriage
Preexisting Conditions:
Allergies: Certain shellfish: conk
Diagnostic Lab Data: If needed I will head to the emergency room. Please follow up with me if necessary
CDC Split Type:

Write-up: Hi I?m 37 years, old woman. My blood pressure raised from 120/80 to 133/92. I am experience a fast beating heart. Heart oalp. My next step is to go to the emergency room if my symptoms don?t absolve itself. I am a healthy, normal weight woman. Others should know about these side effects


VAERS ID: 1525362 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-17
Onset:2021-08-01
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Fatigue, Headache, Myalgia, Olfactory nerve disorder, Oropharyngeal pain, Pyrexia, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), 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)

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

Write-up: Case symptom onset 8/1/21 which included subjective fever, muscle aches, sore throat, olfactory disorders, headache, fatigue, cough, shortness of breath and congestion. Case was not tested for Covid 19 but contact tracer treated as a positive case due to symptoms and 2 household contacts who had tested positive for Covid19.


VAERS ID: 1525629 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Staphylococcal infection
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad)

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

Write-up: Pt reported is currently being treated for a staph infection in the injection arm. was started on bactrim ds 08/03/21


VAERS ID: 1525788 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM

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

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

Write-up: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: SOB reported next day-Mild


VAERS ID: 1525810 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-26
Onset:2021-08-01
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030620A / UNK RA / IM

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

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

Write-up: COVID-19


VAERS ID: 1525827 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blepharospasm, Condition aggravated, Muscle twitching, Pain in extremity, Partial seizures
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levetiracetam, Keppra, Lamotrigine, Nexium
Current Illness:
Preexisting Conditions: Grand Mal and Focal Seizures due to previous traumatic brain injury
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left Arm twitching, left eye twitching, right arm pain, focal seizure in left side of body lasting over 48 hours


VAERS ID: 1525833 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle twitching, Paraesthesia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: statin - 40 mg/zinc/Vit D. Vit C
Current Illness: none
Preexisting Conditions: none
Allergies: sulfur
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Numbness, tingling , swelling in hands, fingers and arms. Twitching/shaking in arms , legs, hands during the night especially and in morning.


VAERS ID: 1525853 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-04
Onset:2021-08-01
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

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

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

Write-up: COVID-19 positive $g 14 days post vaccine series


VAERS ID: 1525923 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Swelling in feet, hands. Sore arm


VAERS ID: 1525928 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: no
Current Illness: no
Preexisting Conditions: no
Allergies: prilosec
Diagnostic Lab Data: no
CDC Split Type:

Write-up: loud ringing in his ear later that night after he rcvd the shot


VAERS ID: 1525933 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Gingival bleeding, Gingival pain, Pain, Papule, Rash, Taste disorder
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Taste and smell disorders (narrow), Gingival disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: over the counter ceterizine allergy pills
Current Illness: none
Preexisting Conditions: none
Allergies: pollen and environmental allergies
Diagnostic Lab Data: none at this time
CDC Split Type:

Write-up: Small skin eruptions (papules) on right hand appeared on August 2. No pain or itching. These appear to be fading as if the date of this report General body aches and tiredness beginning July 31 these are the same as of the date of this report. Mild bleeding and sensitivity from gums beginning on August 1 and continuing as of the date of this report. Moderate foul taste in mouth beginning August 1, and continuing as of the date of this report.


VAERS ID: 1525949 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Scab, 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: atorvaSTATin (LIPITOR) 20 mg tablet, oral, daily sertraline (ZOLOFT) 100 mg tablet, oral, daily
Current Illness: none
Preexisting Conditions: depression, PTSD
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports hives started 48 hours after receiving the vaccine. Today they are starting to scab over.


VAERS ID: 1525993 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-01-11
Onset:2021-08-01
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 2 AR / IM

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

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

Write-up: COVID positive after vaccination


VAERS ID: 1526046 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-02-25
Onset:2021-08-01
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: COVID-19, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: SARS COV-19 NASOPHARYNGEAL SWAB AND PCR POSITIVE 3 AUG 2021.
CDC Split Type:

Write-up: SARS COV-19 INFECTION. CONGESTION, RUNNY NOSE, SORE THROAT.


VAERS ID: 1526079 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-23
Onset:2021-08-01
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: shingles reoccurred. I had shingles in 2008 and the shingrix vaccines 9/2020 and 11/2020


VAERS ID: 1526099 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Abilify; birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Received vaccine on 7/31/2021 at 6pm. Started spotting 8/1/2021 mid-day; heavy flow by 11pm; heavier than typical periods; still spotting lightly on 8/4/21


VAERS ID: 1526106 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-02-02
Onset:2021-08-01
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Warfarin Amiodarone Lisinopril Metoprolol succinate Pravastatin Tussionex Ranitidine Folic acid Multivitamins Cyanocobalamin
Current Illness: Confusion
Preexisting Conditions: Afib Hypertension Hyperlipidemia GERD
Allergies: Esomeprazole Lisinopril Hydrochlorothiazide Bactrim Ciprofloxacin Omeprazole Amoxicillin Yellow dye
Diagnostic Lab Data: Positive COVID test
CDC Split Type:

Write-up: Patient admitted to hospital with COVID breakthrough infection.


VAERS ID: 1526126 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-03
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / UNK - / IM

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

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

Write-up: Incorrect vaccine administered. Patient received Moderna for first dose and was given Pfizer-biontech vaccine for her second dose.


VAERS ID: 1526157 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-04
Onset:2021-08-01
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, COVID-19, Chest pain, Cough, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zanaflex, Lyrica, Metformin, Zetia, clonidine, lipitor, aspirin
Current Illness:
Preexisting Conditions: HTN, NSTEMI, Type two DM, diabetic polyneuropathy, dyslipidemia, CVA, gout,
Allergies:
Diagnostic Lab Data: POS covid swab 8/1/21 in EC
CDC Split Type:

Write-up: cough, chest pain, back pain


VAERS ID: 1526172 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Continuous positive airway pressure, Dyspnoea, Endotracheal intubation, Feeding disorder, Flushing, Intensive care, Mobility decreased, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (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: empagliflozin 10mg, nicotine 7mg/24hr patch, spironolactone 12.5mg, potassium chloride 40mEq, amiodarone 200mg, aspirin 81mg, apixaban 5mg, atorvastatin 80mg, budesonide/formoterol 160-4.5mcg/at 2 puffs, digoxin 0.125mg, docusate 100mg, fur
Current Illness: type 2 diabetes, COPD, paroxsymal Afib, precapillary pHTN, nonischemic HFrEF 15-20% with past history of methamphetamine use who was BIBA due to SOB and wheezing - medication noncompliance
Preexisting Conditions: history of type 2 diabetes, COPD, paroxsymal Afib, precapillary pHTN, nonischemic HFrEF 15-20% with past history of methamphetamine use
Allergies: NKDA
Diagnostic Lab Data: CXR ordered, antibiotic given, BVG sent, breathing tx given twice, RT came and put pt on high flow at 45L 40%. Pt was getting Tachy, Md notified. This RN went to lunch and break RN called Rapid Response because pt c/o not able to stand the high flow. They tried to put pt on a face CPAP while waiting to transfer pt to ICU 8/2/21. Pt intubated in ICU 8/2/21.
CDC Split Type:

Write-up: Per report pt started to have SOB night of 8/1/21. During the day, 8/2/21 was not able to even eat. Started on 5L via NC, face was flushed, hadexternal cath because pt was unable to get out of bed. MD notified. CXR ordered, antibiotic given, BVG sent, breathing tx given twice, RT came and put pt on high flow at 45L 40%. Pt was getting Tachy, Md notified. This RN went to lunch and break RN called Rapid Response because pt c/o not able to stand the high flow. They tried to put pt on a face CPAP while waiting to transfer pt to ICU. Pt intubated in ICU


VAERS ID: 1526200 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-08-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, COVID-19, Eye irritation, Headache, Hyperaesthesia, Nausea, Pain of skin, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Upper-airway cough syndrome
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Arthritis (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: Cholecalcif; Folic Acid
Current Illness: N/a
Preexisting Conditions: No
Allergies: N/a
Diagnostic Lab Data: Covid test: positive 8/3/21
CDC Split Type:

Write-up: Congestion, post nasal drip, severe back pains, skin pains and sensitivity, joint pain, fever, burning eyes, headaches, nausea


VAERS ID: 1526204 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-14
Onset:2021-08-01
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Suspected covid breathrough


VAERS ID: 1526207 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

Administered by: Unknown       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 vaccine was expired by 1 day of manufacture expiration date.


VAERS ID: 1526214 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / IM

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

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

Write-up: the vaccine was expired by 1 day of the manufactures expiration date.


VAERS ID: 1526219 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / IM

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

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

Write-up: the vaccine was expired by 1 day of the manufactures expiration date.


VAERS ID: 1526229 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / IM

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

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

Write-up: the vaccine was expired by 1 day of the manufactures expiration date.


VAERS ID: 1526239 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-02
Onset:2021-08-01
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Choking, Cough, Headache, Ocular discomfort, SARS-CoV-2 test positive, Sinus disorder, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Taste and smell disorders (narrow), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: This 43-year-old female presents to the emergency department for evaluation of headache. Pt states that she has had HA ongoing since Sunday. She was seen here for same then. States that since that time she feels that the HA has gotten worse and has developed loss of sense of taste and smell. States that she feels crackling in her sinus and is concerned for CSF leak secondary to coughing/choking episode the other day. Also reports post nasal drip. No fevers, chills, nausea, vomiting, chest pain, SOB, dizziness, lightheadedness, states that she has pressure behind her eyes but has no vision changes. States that she has no other concerns at this time. She has not had any recent head injury. No recent travel or procedure. She is otherwise at her baseline state of health. HA called 10/10 throbbing while sitting or standing and 7/10 with laying flat. Reports loss of taste and smell since last visit to ED Patient had CT negative for acute intracranial findings on 8/1/21 and is concerned for worsening sx. She is scheduled for neurology follow up on Friday. Will obtain COVID test due to loss of taste and smell. COVID test + All labs and imaging studies have been reviewed and results have been discussed with patient/family. Diagnosis: Covid PLAN: 1. tylenol 2. fluids 3. Follow up with PCP Continue to monitor for new and worsening symptoms. Patient/family understand that this is a provisional diagnosis that can and may change. If symptoms worsen or fail to improve or new symptoms arise, patient should seek re-evaluation either here or with PCP. All questions are answered and patient/family is agreeable to plan of care.


VAERS ID: 1526240 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

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

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

Write-up: the vaccine was expired by 1 day of the manufactures expiration date.


VAERS ID: 1526266 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-08-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Contusion, Dehydration, Dizziness, Electric shock sensation, Fatigue, Feeling abnormal, Nausea, Pain, Retching, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Dehydration (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: vsafe

Write-up: After I got my shot, it felt like a shock in my body. It went down my arm and went down my body on the left side. She grabbed my arm after she took out the needle and it bruised my arm. She was shaking my arm after she administered the vaccine. She grabbed me kind of hard. I went and sat down for 10 minutes afterwards. I think I went to Costco after I left there. I was still feeling alright. Then I went home. I don''t recall what time I went to sleep. I slept all day Saturday. I was very fatigued. I think I woke up at about 9PM that night. I was up for several hours before I went back to sleep. When I was sleeping on Saturday, I noticed that when I turned my head all the way into the pillow, I was feeling a little bit of a dizzy spell. At about 3AM Sunday morning, I felt nausea and dizziness. I got up to go to the bathroom and it was like my head had gone crazy. I couldn''t see anything clearly. My head felt like it was just knocking from left to right. I felt like I was going to fall. I started throwing up. I threw up before I got to the toilet. It was like a mucus. It tasted very bitter. I sat down on the toilet but I was already throwing up. I was just throwing up all over. I am not sure how long I sat there. There was nothing in my stomach and I was just throwing up bile. I was dehydrated at that time because I had not had anything to drink. I stayed in the bathroom on a rug for some time. I don''t remember how long I was in there. I was basically dry heaving. Whatever bile and acid that was left in my stomach, I was throwing it up. My stomach started hurting from the vomiting. I called the local dispatch. I didn''t want to leave the house. I wanted to see if I could talk to someone at a local ER. She told me that she couldn''t give me any medical advice on the phone. I told her I didn''t want to leave the house and she asked me for my address. She was rude. I told her I didn''t want anybody coming to my apartment. She got snippy with me. I didn''t want to leave the apartment because I didn''t want the neighbors to see me being taken away by paramedics. I was in no condition to drive. The next day, I thought about driving over to a hospital then. I was not sure about what kind of medical coverage I had so I tried to ride it out. I just felt awful all day Sunday and Monday. I am trying to cope with this. I try not to move too quickly. I try not to turn my head too far to the left. I just got up a little while ago to go to the bathroom. I''m feeling pretty bad off. It feels like the movement in my head is getting more and more limited. I get nauseated when I look down. If I move my head even slightly to the left or right, my neck starts to lock. My stomach is hurting. I also get nausea. I threw up this morning also. I can''t keep hardly anything down. I sipped on some distilled water in the bathroom and I started throwing that up. I was just trying to hydrate. I also had some crackers off and on. I also have had some herbal tea. I have been lying down on the couch. It takes me a long time to get up because I am very dizzy. My head is spinning now even more. When I tried to get up this morning, my head started to immediately spin. It is very hard to get up. I have to walk very, very slowly so that I don''t fall. I''ve never felt anything like it. I have had vertigo before in 2016, so I know what that feels like. This is far worse than that. My head feels like it is violently thrashing from side to side. I called the clinic and spoke to a doctor who told me to go to the ER right away. I feel like I''m not going to make it. I feel like I''m either going to die from this, or fall and hit my head. There is nobody to call to help me out. My sensitivity to motion has gotten much worse. It''s like a persistence. I can barely move my head at all without getting dizzy. My vision is very blurry. I am not sure if I am seeing double or not. My speech is very slow. I have basically just been staying lying down. I have so much fatigue. I am just so tired. I am worn out. I am very achy and is exaggerates my dizziness.


VAERS ID: 1526274 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-07-28
Onset:2021-08-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit b,c,d, glucosamine, ibuprofen 800mg/day.
Current Illness: Tooth pain, reason for ibuprofen.
Preexisting Conditions: Cpap for sleep apnea.
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right hand is partially numb, mostly the thumb, but also the next three fingers are slightly numb.


VAERS ID: 1526289 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-20
Onset:2021-08-01
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms, Pain, Pain in extremity
SMQs:, Dystonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient is experiencing extreme pain in her body. She does not have arthritis and her hand cramped up and she had to loosen it up her self and now she is having constant pain one of her fingers.


VAERS ID: 1526324 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms, Muscular weakness, Paraesthesia, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: None
Current Illness: No
Preexisting Conditions: No
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tingling all over body, pins and needles, swelling in arm. Muscle weakness and cramping.


VAERS ID: 1526329 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-08-01
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

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

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

Write-up: COVID0-19 positive.


VAERS ID: 1526365 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-08-01
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

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

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

Write-up: Covid-19


VAERS ID: 1526545 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Chills, Headache, Tremor, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Extreme shaking from chills, temperature of 104, entire body broke out in hives, and headache


VAERS ID: 1526550 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: DPT shot/ unknown age less than 5y/o
Other Medications: Nothing taken within 12 hours of vaccination - ativan 0.5 taken 7/29/21 at 10:00PM - Tylenol taken after vaccination 6:30PM 7/30/21
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Codeine
Diagnostic Lab Data: Venous upper extremity doppler - 8/2/2021
CDC Split Type:

Write-up: Two seperate swollen, red, hot lumps in upper right arm. One directly where vaccine was injected, other slightly below injection site. Treating with cool compresses and ibuprofen 400mg every 8 hours. Still experiencing symptoms 3 days later.


VAERS ID: 1526933 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-25
Onset:2021-08-01
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 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? 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: Fully vaccinated and tested positive for COVID-19


VAERS ID: 1527155 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site pain, Injection site swelling, Lymphadenopathy, Neck pain, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B12,& D3, Meloxicam, Tizanidine(all taken the night before)
Current Illness: N/A
Preexisting Conditions: Migraines
Allergies: Doxicycline
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Body aches, chills, Headache in neck/base of head, leg aches, injection site soreness, Very swollen lymph nodes in armpit, injection site swelling, fatigue, slight fever(on and off)


VAERS ID: 1527335 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Very swollen and sore lymph nodes in armpit on the side the shot was given. Lasting for 5 days and counting. A very itchy rash with large bumps appeared on the arm where the shot was given 6 days after the shot.


VAERS ID: 1527339 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-01-29
Onset:2021-08-01
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cold sweat, Cough, Fatigue, Hypogeusia, Hyposmia, Nasal congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hyperlipidemia, prediabetes, allergic rhinitis
Allergies: ibuprofen
Diagnostic Lab Data: COVID positive PCR on 08/03/2021
CDC Split Type:

Write-up: cough, nasal congestion, runny nose, cold sweats, decreased taste, decreased smell, fatigue with COVID positive PCR on 08/03/2021


VAERS ID: 1527343 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-06-21
Onset:2021-08-01
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Headache, Oropharyngeal pain, Pain, Rhinorrhoea, SARS-CoV-2 test positive
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril
Current Illness: None
Preexisting Conditions: Diabetes, CKD-3, proteinuria
Allergies: None
Diagnostic Lab Data: COVID positive PCR on 08/03/2021.
CDC Split Type:

Write-up: Cough; runny nose; body aches; chills; sore throat; headache with COVID positive PCR on 08/03/2021.


VAERS ID: 1528157 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Headache, Joint stiffness, Malaise, Neck pain, Pyrexia, Sluggishness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (One beer a month); Allergy; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Back surgery (about 6 years ago); Comments: The patient had no history of drug abuse or illicit drug use
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210804959

Write-up: LOWER BACK PAIN; NECK PAIN; STIFF ELBOW/ARM WHERE HE GOT HIS SHOT IS STIFF; FEEL SLUGGISH; DID NOT FEEL WELL; JOINT PAIN/SORE ELBOW/ARM WHERE HE GOT HIS SHOT IS SORE; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 63 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included back surgery, and concurrent conditions included alcohol user, non-smoker, and sinus allergies, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 205A21A expiry: UNKNOWN) dose was not reported, administered on 30-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-AUG-2021, the subject experienced lower back pain. On 01-AUG-2021, the subject experienced neck pain. On 01-AUG-2021, the subject experienced stiff elbow/arm where he got his shot is stiff. On 01-AUG-2021, the subject experienced feel sluggish. On 01-AUG-2021, the subject experienced did not feel well. On 01-AUG-2021, the subject experienced joint pain/sore elbow/arm where he got his shot is sore. On 01-AUG-2021, the subject experienced fever. On 01-AUG-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fever, headache, lower back pain, neck pain, stiff elbow/arm where he got his shot is stiff, and joint pain/sore elbow/arm where he got his shot is sore, and the outcome of did not feel well and feel sluggish was not reported. This report was non-serious.


VAERS ID: 1528633 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-19
Onset:2021-08-01
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Discomfort, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Similar left arm pain in left are as which I experienced after first injection. Very uncomfortable for 4 days.


VAERS ID: 1528635 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-26
Onset:2021-08-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Shingles appeared on my left abdominal area(got shot in my left arm) roughly a week after vaccination.


VAERS ID: 1528642 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Dyspnoea, Magnetic resonance imaging, Pain in extremity, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adivan
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Ultrasound 08/02/2021 MRI 08/02/2021
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose Phizer 07/30/2021 (Noted 07/30/2021 MMR 1st dose received), started experiencing symptoms 08/01/2021 of pain throughout the right leg and shortness of breath. 08/02/2021 Primary visit and was determined to have a blood clot located in the PVT calf. Prescribed a blood thinner. (Previous history of DVT 13yrs). Recommendation to continue prescription with follow up to ER if continue or shortness of breath.


VAERS ID: 1528650 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Herpes zoster, Musculoskeletal pain, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C Vitamin D Magnesium B-12
Current Illness: None
Preexisting Conditions: None
Allergies: Wheat Dairy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore arm, pain on right side of hip and rear end, tingling sensation, started breaking out in Shingles on the right side from top of rear end to the bottom of rear end


VAERS ID: 1528711 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Echocardiogram, Echocardiogram normal, Electrocardiogram repolarisation abnormality, Pleuritic pain, Sinus rhythm, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (narrow), Conduction defects (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: asthma
Allergies: n/a
Diagnostic Lab Data: 08/02/2021-elevated troponin 4.91, transthoracic echocardiogram unremarkable, ECG with sinus rhythm and early repolarization 08/03/2021-troponin peaked at 14.2
CDC Split Type:

Write-up: Developed shortness of breath, cough, pleuritic chest pain with 24-48 hours of second dose. Presented to hospital for evaluation when symptoms didn''t resolve with Motrin


VAERS ID: 1528746 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-27
Onset:2021-08-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / SYR

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

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

Write-up: Swelling and large red spot, shoulder pain


VAERS ID: 1528775 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dry mouth, Feeling abnormal, Headache, Lethargy, Nausea, Pain, Sleep disorder, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sodium Ascorbate
Current Illness: None
Preexisting Conditions: None
Allergies: Codeine, walnuts
Diagnostic Lab Data: Going to doctor Saturday 8/6
CDC Split Type:

Write-up: Day of injection, got a headache and have had headache ever since. Did not sleep AT ALL Saturday nite (day of injection). Sunday felt nauseous and felt like I was going to have diarrhea, but never had either. Still have these symptoms on day 5. I''ve been dizzy and light-headed since Sunday. Extreme brain-fog. Blurry vision. Aches and pains, especially where I''ve had surgeries/injuries (back/breasts/foot). I wake up feeling WORSE every day. Extremely lethargic (this gets worse every day). EXTREME cotton-mouth since Sunday. I have NEVER felt so bad in my entire life, even after surgeries


VAERS ID: 1528856 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 presented to the pharmacy with a DOB of 8/1/2003, which would have made him 18 the day of administration, to receive his COVID-19 vaccine. After vaccination we were able to determine via his insurance plan that the patient had falsified his DOB to receive a the vaccine.


VAERS ID: 1528893 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-22
Onset:2021-08-01
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline- 50 mg; Bystolic - 5 mg; Flonase nose spray; Zyrtec; Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: Medications - Codeine, Take allergy shots for a multitude of environmental allergens - 2 shots once a week
Diagnostic Lab Data: none at this time
CDC Split Type:

Write-up: On the 10th day after receiving the 1st dose of the Moderna vaccine, a red, swollen hot whelp appeared at the injection site. I am reporting this on day 4 after taking 4 doses of Benadryl and applying Hydrocortisone many times. The site measures 6 inches by 5 inches. I am seeking medical advice from my PCP later today.


VAERS ID: 1528894 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-06
Onset:2021-08-01
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Mesenteric vein thrombosis, Thrombectomy
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Ischaemic colitis (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: lisinopril, fenofibrate
Current Illness: none
Preexisting Conditions: TIA, colon polyps, diverticulitis
Allergies: none
Diagnostic Lab Data: CT abdomen and pelvis confirming diagnosis
CDC Split Type:

Write-up: mesenteric vein thrombosis, has been transferred to outside hospital for thrombectomy at time of this report


VAERS ID: 1528906 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-08-01
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion threatened, Exposure during pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (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: Threatened miscarriage in early pregnancy Vaginal bleeding


VAERS ID: 1528926 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-13
Onset:2021-08-01
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / UNK LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / UNK LA / IM

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

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

Write-up: Positive for Covid 8/3/21


VAERS ID: 1528950 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-08
Onset:2021-08-01
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: positive covid19 PCR test, 8/3/21
CDC Split Type:

Write-up: fully vaccinated (moderna, 2/8/21, 3/8/21); onset of symptoms 8/1/21


VAERS ID: 1528970 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: patient was 17 weeks pregnant at the time, patient experienced an episode of fainting roughly 5-7 minutes following vaccination


VAERS ID: 1528983 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-08-01
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: positive covid19 PCR 8/3/21
CDC Split Type:

Write-up: fully vaccinated (Pfizer, 1/11/21, 2/1/21); onset of symptoms 8/1/21


VAERS ID: 1529012 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-15
Onset:2021-08-01
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Headache, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), 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), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: tested positive for COVID on 8/4/2020
CDC Split Type:

Write-up: Patient developed symptoms including cough, fever, new loss of taste or smell, fatigue, body aches, headache, sore throat, and runny nose on 08/01. He tested positive for COVID on 8/4/2020


VAERS ID: 1529077 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Pain, Pyrexia, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sunday evening (date of vaccination 8/1/21), patient reported deep chills, body aches, spinning dizzy vertigo and fever which lasted till today 08/5/21. Patient reported having the same symptoms she experienced when she had covid in Oct 2020. She is still suffering from a severe, non-stop headache that she is still taking Tylenol for.


VAERS ID: 1529088 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-04
Onset:2021-08-01
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / UNK - / -

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

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

Write-up: Vaccine Breakthrough COVID + 8/1/21. Inpatient hospitalization for dyspnea. Inpatient telemetry unit


VAERS ID: 1529136 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-16
Onset:2021-08-01
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Respiratory distress, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Vaccine Breakthrough COVID + 8/1/21. Symptomatic COVID + test in ED for respiratory distress. Discharged to home.


VAERS ID: 1529154 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-23
Onset:2021-08-01
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFEU5318 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abscess intestinal, Biopsy intestine abnormal, Colitis, Colonoscopy abnormal, Eructation, Gastrointestinal disorder, Gastrointestinal inflammation, Gastrooesophageal reflux disease, Haematochezia, Steatorrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal perforation (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 25mg of Metoprolol 1xday; 1mg of Lorazepam 4xdaily; 600mg Gabapentin 3xday; Zyrtec; occasionally Vitamin D
Current Illness: i was having recurring kidney infections
Preexisting Conditions: Mitral Valve Prolapse; Hashimoto''s; Crohns Disease that was in 3 year remission until recently
Allergies: Acyclovir; Flexeril; Doxycycline
Diagnostic Lab Data: They did a colonoscopy and it showed that I had chronic inflammation in small and large valve intestines and the rectum. There are some cryptates and abscess formation. Lymphocytes and plasma cells were all over the biopsy of the intestine that they took.
CDC Split Type: vsafe

Write-up: After the 2nd dose I started noticing I was experiencing some gastrointestinal issues that were getting worse like GERD. I was burping up a lot of acid and had weird stomach issues I couldn''t explain. A few weeks ago i got really sick out of nowhere and my diet or nothing had changed. I went to the ER and they gave me steroids and said I had pancolitis (inflammation all over my intestines). I went home and Took the steroids and got worse. I was pooping blood and fat and couldn''t keep anything down, either throw it up or poop it out. I went back to the ER and was admitted for a week and now on heavy steroids. They said the pancolitis got worse and the steroids they gave wasn''t helping.


VAERS ID: 1529194 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bundle branch block right, Electrocardiogram, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (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: Lisinopril 20 Atorvostatin
Current Illness:
Preexisting Conditions: HTN, hyperlipid, Obesity
Allergies: NKDI
Diagnostic Lab Data: off record ECG 8/30/2021
CDC Split Type:

Write-up: Began experiencing intermittent cardiac rhythm disturbance Sunday afternoon, no chest pain, no SOB. Did not resolve, I was in the ED to care for a patient and asked a collogue to hook me up to a cardiac monitor. ECK identified "incomplete right bundle branch block". As of the time of reporting the symptoms have not resolved or increased in frequency.


VAERS ID: 1529204 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-01-16
Onset:2021-08-01
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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 12/24/21pfizer,Lot#EK9231 2nd dose: 01/16/21,Pfizer,Lot# EL3247 Diagnosed covid positive:08/01/21 Symptom onset:07/31/21 Exposure:unknown Symptoms:Fever, cough,muscle aches,chills,headache.


VAERS ID: 1529235 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-08-01
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol (ZYLOPRIM) 300 MG PO Tablet 7/1/19 Information, Historical amLODIPine (NORVASC) 5 MG PO Tablet 7/1/19 atorvastatin (LIPITOR) 80 MG PO Tablet 7/1/19 budesonide-formoterol (SYMBICORT) 160-4.5 MCG/ACT inhaler In
Current Illness:
Preexisting Conditions: Hyperlipemia ? Hypertension ? Peripheral vascular disease ? Prostate cancer
Allergies: NKDA
Diagnostic Lab Data: SARS-COV-2, NAA Detected 08/01/21
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. He received Pfizer vaccine second dose in series on 06/03/21. Hospitalized from 08/01/21 - 08/04/21. Below is copied from discharge summary: Patient is a 81 y.o. with a PMH of HTN, HLD, PVD who presented with generalized weakness for the last several days and postural dizziness. Patient denies having any complaints at the time of interview and would like to go home. Collateral information gathered from ED and daughter. Apparently patient is poorly compliant with medications at home, but is prescribed some antihypertensive meds. Otherwise is usually in good health and recently saw his PCP. Received both doses of COVID vaccine, but is found to be COVID + and with new oxygen requirement in the ED Pt discharged. Transported via wheelchair downstairs to daughter. Pt belongings sent with pt. Discharge instructions given and pt states to understand. IV removed.


VAERS ID: 1529595 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest pain, Extrasystoles, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Dehydration (broad), Hypokalaemia (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: Trazodone
Current Illness: None
Preexisting Conditions:
Allergies: Cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain, elevated heart rate, elevated blood pressure, palpitations, skipped beats. Symptoms continuing for at least 2 weeks following vaccination. So far visited ER and symptoms continuing.


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