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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 305 out of 7,116

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VAERS ID: 1593191 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Chest pain, Condition aggravated
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

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

Write-up: Continuous dull heart pain since the day after the injection. When I was walking up a moderate hill the center of my chest was burning/feeling of needles. I?ve never experienced this before ever. I had some heart pain when inhaling after the first shot, but it?s been more severe and more pronounced after this second shot


VAERS ID: 1593192 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-28
Onset:2021-08-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Disorientation, Dizziness, Migraine, Nausea, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Hypoglycaemia (broad), Dehydration (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: Intense migraines, dizziness, nausea, disoriented, vomiting, vertigo.
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme migraine nausea vomiting dizziness disoriented vertigo symptoms lasted for two weeks


VAERS ID: 1593193 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Discomfort, Fear, Pain, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderate swelling at injection site; redness extending 4-5 inches beyond injection site; warm to touch at injection site; extrem
Other Medications: Zoloft Ibuprofen Prenatal vitamin
Current Illness: None
Preexisting Conditions: Mild intermittent asthma without complication Psoriasis
Allergies: Prevnar-13 Bupropion
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joint pain throughout body. Began around day 4. Worse at night. Most frequently in ankles, shoulders, and wrists. Occasionally in knees, toes, fingers, elbows. Taking ibuprofen. Have not reported to dr as it is pretty mild and mostly more of an annoying discomfort. Fearful it may become worse but hopeful it will go away.


VAERS ID: 1594318 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Adverse drug reaction, Body temperature, Feeling abnormal, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: 102
CDC Split Type: USJNJFOC20210828897

Write-up: REALLY SEVERE BODY PAIN; VACCINE KICKED MY BUTT; ENCOUNTERED EVERY SINGLE SIDE EFFECT LISTED BY J&J; NEVER HONESTLY FELT SO SICK IN MY LIFE; 102 TEMPERATURE 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: Unknown) dose was not reported, administered on AUG-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 AUG-2021, the patient experienced really severe body pain. On AUG-2021, the patient experienced vaccine kicked my butt. On AUG-2021, the patient experienced encountered every single side effect listed by j&j. On AUG-2021, the patient experienced never honestly felt so sick in my life. On AUG-2021, the patient experienced 102 temperature fever. Laboratory data included: Body temperature (NR: not provided) 102. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from never honestly felt so sick in my life, 102 temperature fever, really severe body pain, vaccine kicked my butt, and encountered every single side effect listed by j&j. This report was non-serious.


VAERS ID: 1594332 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Lung disease; Nerve damage (Related to the thymoma); Non-smoker; Pneumonia recurrent (Currently had pneumonia not related to covid but related to the thymoma)
Preexisting Conditions: Medical History/Concurrent Conditions: Thymoma (Removed 5 years ago followed by radiation treatment); Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210829316

Write-up: CONFIRMED COVID-19 INFECTION; CONFIRMED CLINICAL VACCINATION FAILURE; This spontaneous report received from a health care professional concerned a 56 year old male of an unspecified race and ethnic origin. The patient''s height and weight were not reported. The patient''s past medical history included thymoma (removed 5 years ago followed by radiation treatment) and concurrent conditions included he had recurrent pneumonia (not related to covid but related to the thymoma), non-alcohol user, non-smoker, left lung disfunction, nerve damage on the left side (related to the thymoma) and other pre-existing medical conditions included he had no known allergies. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982, expiry: unknown) dose was not reported, 1 total administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient had confirmed covid-19 infection and confirmed clinical vaccination failure. On 12-AUG-2021 he was hospitalized for Covid. The number of days hospitalized was not reported. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the confirmed clinical vaccination failure and confirmed covid-19 infection was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender''s Comments: V0-20210829316-COVID-19 Vaccine AD26.COV2.S-Confirmed Covid-19 Infection, Confirmed Clinical Vaccination Failure- This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1594349 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: SARS-CoV-2 rapid antibody test; Result Unstructured Data: Negative for IgM IgG
CDC Split Type: USJNJFOC20210832350

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a male patient of unspecified age. 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: 1802072 expiry: UNKNOWN) dose was not reported, 1 total administered on 10-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. In AUG-2021, the patient used the (IgG antibody test) to assess his IgG and the result was negative (confirmed immunological vaccine failure). He stated that other patients who received an mRNA vaccine get a positive test for IgG when this test was used. Laboratory data included: SARS-CoV-2 rapid antibody test (NR: not provided) Negative for IgM IgG. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 20210832350-COVID-19 VACCINE AD26.COV2.S-confirmed immunological vaccine failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1594355 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abnormal behaviour, Back pain, Burning sensation, Fatigue, Feeling hot, Gastrooesophageal reflux disease, Pain, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific dysfunction (narrow), Hostility/aggression (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: Gastrooesophageal reflux disease (She started to have more acid reflex which came up again after being quiet before getting vaccination.); Hypertension; Stomach ulcer (Taking medication for that).
Preexisting Conditions: Medical History/Concurrent Conditions: Pulmonary thrombosis.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210832442

Write-up: MORE ACID REFLEX; EXHAUSTION WAS A DIFFERENT TYPE OF TIREDNESS AS IF SHE WAS COMING FROM ILLNESS/ EXTREMELY TIRED; STINGING THROUGH THE KIDNEY, MAINLY THE RIGHT SIDE FOR 1-2 MINUTES; LOWER BACK PAIN; BURNING IN LEGS AND FEET (BURNING, HOTNESS, HEAT IN THE BACK OF LEGS IN THE CALF AREA) AND BOTHERED BY THE ACHENES FEELING, LEGS ARE BURNING HOT WHEN SHE TOUCHES HER LEGS, THEY ARE NOT HOT AND NO PAIN, FEELS THAT THEY ARE HOT (HOT SENSATION); DID NOT SLEEP GOOD WHICH LASTED FOR 3-4 NIGHTS; DRIVING HER CRAZY; IT IS JUST HOW SHE FEELS THAT THEY ARE HOT( HOT SENSATION); This spontaneous report received from a patient concerned a 76 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: blood clots in the lungs, and concurrent conditions included: hypertension, stomach ulcer, and acid reflex. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: UNKNOWN) dose was not reported, administered on 10-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced driving her crazy. On AUG-2021, the patient experienced it is just how she feels that they are hot ( hot sensation). On 10-AUG-2021, the patient experienced stinging through the kidney, mainly the right side for 1-2 minutes. On 10-AUG-2021, the patient experienced lower back pain. On 10-AUG-2021, the patient experienced burning in legs and feet (burning, hotness, heat in the back of legs in the calf area) and bothered by the achenes feeling, legs are burning hot when she touches her legs, they are not hot and no pain, feels that they are hot (hot sensation). On 10-AUG-2021, the patient experienced did not sleep good which lasted for 3-4 nights. On 10-AUG-2021, the patient experienced exhaustion was a different type of tiredness as if she was coming from illness/ extremely tired. On an unspecified date, the patient experienced more acid reflex. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from did not sleep good which lasted for 3-4 nights on 14-AUG-2021, had not recovered from burning in legs and feet (burning, hotness, heat in the back of legs in the calf area) and bothered by the achenes feeling, legs are burning hot when she touches her legs, they are not hot and no pain, feels that they are hot (hot sensation), and the outcome of stinging through the kidney, mainly the right side for 1-2 minutes, lower back pain, exhaustion was a different type of tiredness as if she was coming from illness/ extremely tired, more acid reflex, driving her crazy and it is just how she feels that they are hot( hot sensation) was not reported. This report was non-serious.


VAERS ID: 1594356 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Exostosis, Muscle spasms, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210832448

Write-up: EYESIGHT WAS TOTALLY BLURRED (BOTH EYES SHE COULD NOT SEE) AND FAILED A DRIVING RENEWAL TEST DUE TO THIS; BOTH LEGS CRAMPED ALL THE TIME; PAINFUL BONE SPUR ON THE LEFT FOOT (SOMETHING HARD ON THE TOP OF HER FOOT AND IT WAS PAINFUL); This spontaneous report received from a patient concerned a 74 year old female. 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, intramuscular, batch number: 206A21A, and expiry: UNKNOWN) dose was not reported, administered on 28-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-AUG-2021, the patient experienced both legs cramped all the time. On 01-AUG-2021, the patient experienced painful bone spur on the left foot (something hard on the top of her foot and it was painful). On 12-AUG-2021, the patient experienced eyesight was totally blurred (both eyes she could not see) and failed a driving renewal test due to this. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from eyesight was totally blurred (both eyes she could not see) and failed a driving renewal test due to this, and had not recovered from both legs cramped all the time, and painful bone spur on the left foot (something hard on the top of her foot and it was painful). This report was non-serious.


VAERS ID: 1594380 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816024 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Eye irritation, Rash, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PLAVIX
Current Illness: Heart disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210834794

Write-up: ITCHY RASH ON ARMS; RASH; RASH/HIVES ON BOTH ARMS FROM WRIST TO SHOULDER; SCRATCH EYES OUT; This spontaneous report received from a consumer concerned a 66 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: heart disease. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1816024, and expiry: 29-SEP-2021) dose was not reported, administered on 03-AUG-2021 for prophylactic vaccination. Concomitant medications included clopidogrel bisulfate for heart disorder. On AUG-2021, the patient experienced scratch eyes out. On AUG-2021, the patient experienced rash. On AUG-2021, the patient experienced rash/hives on both arms from wrist to shoulder. On 06-AUG-2021, the patient experienced itchy rash on arms. Treatment medications (dates unspecified) included: camphor/diphenhydramine hydrochloride/zinc oxide, prednisone, betamethasone valerate, and diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from itchy rash on arms, and rash, had not recovered from rash/hives on both arms from wrist to shoulder, and the outcome of scratch eyes out was not reported. This report was non-serious.


VAERS ID: 1594383 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210801; Test Name: COVID-19 antigen test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210834806

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient via a company representative concerned a 60 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029 expiry: UNKNOWN) dose was not reported, 1 total, administered on 07-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date patient had no complaints except fatigue. On 01-AUG-2021, the patient had COVID-19 antigen test which resulted in positive (suspected clinical vaccination failure and suspected covid-19 infection). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint:90000189953.; Sender''s Comments: V0- 20210834806- covid-19 vaccine ad26.cov2.s -Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1594389 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: COVID-19 antibody test; Result Unstructured Data: negative for antibodies
CDC Split Type: USJNJFOC20210834860

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a female of an unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: Unknown) dose was not reported, 1 total, administered on an unspecified date in MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date in AUG-2021, the patient was asking about the need of a booster of covid-19 vaccine or getting another vaccine brand after testing negative for antibodies (confirmed immunological vaccine failure) and the patient had visited physician/healthcare professional office. Laboratory data included: COVID-19 antibody test (NR: not provided) negative for antibodies. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0-20210834860-COVID-19 VACCINE AD26.COV2.S-Confirmed Immunological Vaccine Failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1594391 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210834870

Write-up: This spontaneous report received from a consumer via a company representative concerned multiple patients. 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 AUG-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 AUG-2021, the patient experienced chills. On AUG-2021, the patient experienced fever in night. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chills and fever in night was not reported. This report was non-serious. This case, from the same reporter is linked to 20210835180.


VAERS ID: 1594396 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Deaf; Eye disorder; Penicillin allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: 102 to 100.5 F
CDC Split Type: USJNJFOC20210834936

Write-up: CHILLS; FEVER FOR 3 DAYS BETWEEN 102 F TO100.5; This spontaneous report received from a patient concerned a 57 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: deaf, eye disease, and penicillin allergy. The patient experienced drug allergy when treated with vancomycin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 13-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced chills. On AUG-2021, the patient experienced fever for 3 days between 102 f to100.5. Laboratory data included: Body temperature (NR: not provided) 102 to 100.5 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever for 3 days between 102 f to100.5 on AUG-2021, and had not recovered from chills. This report was non-serious.


VAERS ID: 1594397 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Fatigue, Feeling abnormal, Headache, Nausea, Pain, Pyrexia, Tension headache
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre 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: Blood pressure high
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210834963

Write-up: BAD BODY ACHES; TIREDNESS/FELT EXHAUSTED; NAUSEA; FEVER; HEADACHE; TENSION HEADACHE; DID NOT FEEL LIKE MY NORMAL SELF; TOOK 2 DAYS OFF WORK BECAUSE COULD NOT GET UP; This spontaneous report received from a patient concerned a 48 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: high blood pressure. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: UNKNOWN) dose was not reported, administered on 09-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced did not feel like my normal self. On AUG-2021, the patient experienced took 2 days off work because could not get up. On AUG-2021, the patient experienced tension headache. On 09-AUG-2021, the patient experienced headache. On 10-AUG-2021, the patient experienced bad body aches. On 10-AUG-2021, the patient experienced tiredness/felt exhausted. On 10-AUG-2021, the patient experienced nausea. On 10-AUG-2021, the patient experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nausea on 11-AUG-2021, and fever on 12-AUG-2021, had not recovered from headache, bad body aches, and tiredness/felt exhausted, and the outcome of took 2 days off work because could not get up, did not feel like my normal self and tension headache was not reported. This report was non-serious.


VAERS ID: 1594400 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase, Aspartate aminotransferase, Blood glucose, Blood test, Body temperature, Fatigue, Headache, Hepatic enzyme, Hepatic enzyme increased, Lethargy, Magnetic resonance elastography, Pain in extremity, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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:
Current Illness: Abstains from alcohol; Autism; Non-smoker; Penicillin allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Fatty liver; Renal disease; Comments: Patient had no drug abuse or illicit drug usage. The patient was on a very restricted diet, no sugar, no potassium, no red meat and very low salt intake.
Allergies:
Diagnostic Lab Data: Test Date: 20210524; Test Name: SGPT; Result Unstructured Data: 41; Test Date: 20210524; Test Name: SGOT; Result Unstructured Data: 31; Test Date: 20210524; Test Name: Magnetic resonance elastography; Result Unstructured Data: Fine; Comments: Patient was fine.; Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: 102 F; Test Date: 20210816; Test Name: Glucose; Result Unstructured Data: 144; Comments: It was reported that, patient''s glucose was normal before.; Test Date: 20210816; Test Name: SGPT; Result Unstructured Data: 108; Test Date: 20210816; Test Name: SGOT; Result Unstructured Data: 80; Test Date: 20210816; Test Name: Hepatic enzyme; Result Unstructured Data: High; Test Date: 20210816; Test Name: Blood test; Result Unstructured Data: Not specified
CDC Split Type: USJNJFOC20210835084

Write-up: HIGH LIVER ENZYMES; LETHARGIC; SORE ARM; FEVER; FATIGUE; HEADACHE; This spontaneous report received from a parent concerned a 22 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: kidney disease, and fatty liver disease, and concurrent conditions included: penicillin allergy, non-smoker, non-alcohol user, and autistic, and other pre-existing medical conditions included: Patient had no drug abuse or illicit drug usage. The patient was on a very restricted diet, no sugar, no potassium, no red meat and very low salt intake. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 13-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-MAY-2021, Laboratory data included: Magnetic resonance elastography (NR: not provided) Fine, SGOT (NR: not provided) 31, and SGPT (NR: not provided) 41. On AUG-2021, the patient experienced lethargic. On AUG-2021, the patient experienced sore arm. On AUG-2021, the patient experienced fever. On AUG-2021, the patient experienced fatigue. On AUG-2021, the patient experienced headache. Laboratory data included: Body temperature (NR: not provided) 102 F. On 16-AUG-2021, the patient experienced high liver enzymes. Laboratory data included: Blood test (NR: not provided) Not specified, Glucose (NR: not provided) 144, Hepatic enzyme (NR: not provided) High, SGOT (NR: not provided) 80, and SGPT (NR: not provided) 108. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on AUG-2021, had not recovered from fatigue, lethargic, and headache, and the outcome of sore arm and high liver enzymes was not reported. This report was non-serious.


VAERS ID: 1594432 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Vermont  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210837262

Write-up: VACCINE ADMINISTERED AFTER 48 HOURS FROM PUNCTURED VIAL; INCORRECT PRODUCT STORAGE; This spontaneous report received from a health care professional concerned a 49 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A expiry: 21-SEP-2021) dose was not reported, administered on 17-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced incorrect product storage. On 17-AUG-2021, the patient experienced vaccine administered after 48 hours from punctured vial. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered after 48 hours from punctured vial and incorrect product storage was not reported. This report was non-serious. This case, from the same reporter is linked to 20210837503.


VAERS ID: 1594445 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Dependence on respirator, SARS-CoV-2 test, Suspected COVID-19, Vaccination failure, Weight
SMQs:, Lack of efficacy/effect (narrow), Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Atrial fibrillation; Blood pressure high; Diabetes
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Blood test; Result Unstructured Data: Not reported; Test Name: COVID-19 virus test; Result Unstructured Data: Positive; Test Name: Weight; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210837488

Write-up: PUT ON A VENTILATOR; SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a consumer via a company representative concerned a 94 year old male of unspecified race and ethnic origin. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: controlled diabetes, high blood pressure, and atrial fibrillation. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On AUG-2021, the patient experienced suspected covid-19 infection and suspected clinical vaccination failure. On 18-AUG-2021, he was put on a ventilator, and was hospitalized on an unspecified date. Laboratory data (dates unspecified) included: Blood test (NR: not provided) Not reported, COVID-19 virus test (NR: not provided) Positive, and Weight (NR: not provided) Normal. The action taken with covid-19 vaccine was not applicable. The outcome of the put on a ventilator, suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Hospitalization Caused / Prolonged, and Life Threatening).; Sender''s Comments: V0:20210837488- covid-19 vaccine PUT ON A VENTILATOR,SUSPECTED COVID-19 INFECTION. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210837488- covid-19 vaccine SUSPECTED CLINICAL VACCINATION FAILURE,. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1594450 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site pain, Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (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: CITOMIX; VITAMIN C [ASCORBIC ACID]; PROBIOTIC; VIT D; ZINC; ELDERBERRY
Current Illness: Drug allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210837535

Write-up: TWITCHING IN CALVES THAT DESCRIBED AS THE PULSATIONS IN THE BACK OF THE CALVESTWITCHING IN CALVES THAT DESCRIBED AS THE PULSATIONS IN THE BACK OF THE CALVES; HEADACHE; INJECTION SITE PAIN; This spontaneous report received from a patient concerned a 61 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: narcotic pain medications allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 16-AUG-2021 for prophylactic vaccination. Concomitant medications included ananas comosus/animal bone marrow/binetrakin/centella asiatica/interferon gamma/interleukin-1/interleukin-2/interleukin-6/thymus gland/vaccinium vitis-idaea, ascorbic acid, bifidobacterium lactis, ergocalciferol, sambucus nigra, and zinc. On AUG-2021, the patient experienced injection site pain. On 17-AUG-2021, the patient experienced headache. Treatment medications included: paracetamol. On 18-AUG-2021, the patient experienced twitching in calves that described as the pulsations in the back of the calvestwitching in calves that described as the pulsations in the back of the calves. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache on 17-AUG-2021, and injection site pain on AUG-2021, and had not recovered from twitching in calves that described as the pulsations in the back of the calvestwitching in calves that described as the pulsations in the back of the calves. This report was non-serious.


VAERS ID: 1594463 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Discomfort, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), 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:
Current Illness: Abstains from alcohol; Penicillin allergy (Hives, but she had Z-Pak 20 years ago and she was okay.); Smoker (10 cigarettes per day.)
Preexisting Conditions: Medical History/Concurrent Conditions: Bronchitis (Fever, headache, coughing and shortness of breath.); Pneumonia (Fever, headache, coughing and shortness of breath.); Suspected COVID-19 (Fever, headache, coughing and shortness of breath.); Comments: The patient had no history of drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210837925

Write-up: SEVERE MUSCLE DEEP TISSUE PAIN THAT STRETCHED TO POSTERIOR TRAPEZOID, DELTOID AND A LITTLE TO THE QUAD AND GENERALLY TO THE WHOLE BODY; EXTREME DISCOMFORT BUT THERE WAS NO CONTRACTION OR CRAMPING AND NO SWELLING; This spontaneous report received from a patient concerned a 63 year old female. The patient''s weight was 120 pounds, and height was 68 inches. The patient''s past medical history included: suspected covid-19, bronchitis, and pneumonia, and concurrent conditions included: non alcohol user, smoker, and penicillin allergy, and other pre-existing medical conditions included: The patient had no history of drug abuse or illicit drug usage. The patient was previously treated with azithromycin; and experienced drug allergy when treated with erythromycin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820096, and expiry: 21-OCT-2021) dose was not reported, administered on 15-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced extreme discomfort but there was no contraction or cramping and no swelling. On 15-AUG-2021, the patient experienced severe muscle deep tissue pain that stretched to posterior trapezoid, deltoid and a little to the quad and generally to the whole body. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from extreme discomfort but there was no contraction or cramping and no swelling, and severe muscle deep tissue pain that stretched to posterior trapezoid, deltoid and a little to the quad and generally to the whole body on 18-AUG-2021. This report was non-serious.


VAERS ID: 1594487 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820075 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Chest pain, Dizziness, Pain assessment, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood donation (donated whole blood and was wondered if that had anything to do with side effects); Comments: Patient was not pregnant at time of vaccination.
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Pain scale; Result Unstructured Data: burning in chest is a 2 out of 10 on a pain scale of 0 to 10
CDC Split Type: USJNJFOC20210840523

Write-up: This spontaneous report received from a patient concerned a 51 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: donated whole blood, and other pre-existing medical conditions included: Patient was not pregnant at time of vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820075, and expiry: UNKNOWN) dose was not reported, administered on 09-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced burning feeling in chest. On AUG-2021, the patient experienced tight feeling in chest. On AUG-2021, the patient experienced fullness feeling in both calves, more in left leg. On AUG-2021, the patient experienced light headedness, dizziness, woozy feeling. On AUG-2021, the patient experienced anxiety. Laboratory data included: Pain scale (NR: not provided) burning in chest is a 2 out of 10 on a pain scale of 0-10. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from light headedness, dizziness, woozy feeling, burning feeling in chest, fullness feeling in both calves, more in left leg, anxiety, and tight feeling in chest. This report was non-serious.


VAERS ID: 1595947 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-30
Onset:2021-08-01
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Hypoaesthesia, Hypoxia, Pain, Pain in extremity, Paraesthesia, Pulmonary pain, Throat irritation
SMQs:, Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (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: Zinc and Vitamin D
Current Illness: 0
Preexisting Conditions: 0
Allergies: 0
Diagnostic Lab Data: Prior to the development of the symptoms above, I had a nagging sensation of tickling (desire to cough) and slight pain in my lungs. Dr. ordered the following tests on June 28th. Xray Bloodwork These were both normal.
CDC Split Type:

Write-up: I am a very active, healthy 67 y/o female who regularly engages in long bike rides, kayaking, hikes, weight lifting and yoga. Despite continuing to engage in these activities, during the past 6-7 weeks I am experiencing sporadic, but increasingly severe episodes of what appear to be symptoms of hypoxia. At times the feeling of not getting enough air wakes me up at night and continues throughout the day. I am also experiencing numbness and tingling in my hands and feet as well as foot pain which is exacerbated by the pressure of walking.


VAERS ID: 1595948 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (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: 2 days after my first shot, "Covid Arm" developed. A large spot, about the size of 1 and 1/2 tennis balls developed. It was red, hard, hot and was extremely itchy. These side effects lasted for 10 days to 2 weeks. I treated my arm by using Advil, hydrocortizone and neosporin with ice packs.


VAERS ID: 1602598 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Lymphadenopathy, Tenderness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Golf ball size swelling of left axillary lymph node with tenderness and left arm numbness as if ?a tourniquet was placed on the upper arm.? This appeared on the second day after second dose of vaccine lasting about 48 hours. Swelling, tenderness and numbness started to resolve after 48 hours.


VAERS ID: 1602654 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-20
Onset:2021-08-01
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cough, Oropharyngeal pain, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Sore throat, low energy, couch


VAERS ID: 1602854 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-21
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

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

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

Write-up: Second dose was administered on day 14 instead of day 21 without pharmacy realizing.


VAERS ID: 1602920 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-06
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia, Inappropriate schedule of product administration
SMQs:, Taste and smell disorders (narrow), Medication errors (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient had Covid in March 2021, got first vaccine dose in June 2021 and second dose in August 2021. She lost her sense of smell and taste when sick with the virus. They returned after her first shot, but now she has lost her smell again right after the second dose.


VAERS ID: 1603067 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-08
Onset:2021-08-01
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH LOT#EL 9262 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Micrographic skin surgery, Pathology test, Squamous cell carcinoma
SMQs:, Skin malignant tumours (broad), Skin tumours of unspecified malignancy (broad), Non-haematological malignant tumours (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: Levothyroxine, sodium alendronate Bp medicine
Current Illness: None
Preexisting Conditions: Osteopenia
Allergies: Coughing
Diagnostic Lab Data: Surgical pathology on specimen sent to lab. No results to date.
CDC Split Type:

Write-up: Squamous cell cancer on left face. Mohs procedure on 3/2021. Follow up on may1 st


VAERS ID: 1606579 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Joint range of motion decreased, Monoplegia, Muscular weakness, Paraesthesia, Sensory loss, Ultrasound Doppler
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: N/a
Preexisting Conditions: Depression, generalized anxiety, sleep disorder, and panic disorder.
Allergies: No
Diagnostic Lab Data: Exam: US DOPPLER VENOUS ARM LEFT Date/Time of Exam: 8/15/2021 12:02 PM Reason For Exam: Numbness and tingling. Findings: Real-time images of the veins in the left upper extremity were performed with Doppler flow measurements and color flow imaging. There is normal flow. No thrombus. No mass or fluid collection. IMPRESSION: No significant abnormality specifically no evidence of thrombus.
CDC Split Type:

Write-up: Lack of muscle control in the hand arm and shoulder Loss of sensation in the hand arm and shoulder Paralysis in the hand arm or shoulder Sharp stabbing pain in shoulder. Numbness and tingling. Overall muscle weakness. Limited range of motions and movements.


VAERS ID: 1617371 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-03-09
Onset:2021-08-01
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Cardiolipin antibody
SMQs:, 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? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, probiotic
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Augments
Diagnostic Lab Data: Elevated cardiolipin igm
CDC Split Type:

Write-up: Second trimester miscarriage


VAERS ID: 1617376 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Chills, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Temperature more than 100 Fahrenheit, chills, headache, weakness, temperature goes up and down every 30 minutes.


VAERS ID: 1617425 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-23
Onset:2021-08-01
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Breast mass
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Nexium, albuterol inhaler, Vitamin D 2000, Celebrex 200mg, simvastatin 20mg, Singulair 10mg, Xanax 0.5mg, aspirin 81mg
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Adverse reaction to Kenalog injection 120mg total, in year 2010.
Diagnostic Lab Data: Scheduled for Sept 2, 2021
CDC Split Type:

Write-up: Although I do not see a connection, I was advised to report it anyway. Three lumps found in left breast six months after first Pfizer vaccine. Second Pfizer vaccine was received on Feb 14,2021.


VAERS ID: 1617529 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21! / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hydrocodone/apap, diltiazem, furosemide, vitamin d3, tamsulosin, fenofibrate, omeprazole, potassium chloride
Current Illness:
Preexisting Conditions: pain in right shoulder, hypertension, radiculopathy
Allergies: pregabalin, gabapentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/1/21 (day after administration) red, bumpy rash appeared. the following day (8/2/21) he went to md and received steroid shot. 8/10/21 he got steroid cream. still on his arm but does not itch.


VAERS ID: 1617548 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-15
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Influenza like illness, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Pt received Pfizer Covid vaccine 8-1-21 at another facility. We did not know this at the time we administered the Moderna on 8-15-21 and the patient informed staff that he had never received a Covid vaccine before. This was brought to my attention by an RPh as she checked the database when pt presented to her location on 8-22-21 to receive his second dose of Pfizer vaccine. This thus constitutes the second dose in the series being administered too soon as well as being administered with the wrong brand. (We would not have done this if we had known about the first dose being administered elsewhere). I spoke with the patient 8-22-21 and he stated he had not had any adverse effects other than mild flu-like symptoms. I advised him the series is considered complete now.


VAERS ID: 1617616 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-07-25
Onset:2021-08-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

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

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

Write-up: Patient made an appointment via tool and filled out covid-19 vaccine informed consent form electronically which was automatically faxed to the pharmacy. Patient reported on the consent form that she had never received a previous dose of covid-19 vaccine. When patient came to the pharmacy, she told the technician that this was her first Covid-19 vaccine which was documented at the top of the electronically generated consent form. Additionally, when went into immunization room with the patient the rph verified verbally verified that this was her first covid-19 vaccine confirming what the patient noted on her consent form. Patient had second appointment schedule for 8/22/21 at 1:15pm. Upon checking Immpact(Maine immunization information system) on the morning of 8/22/21, it showed that the patient had received first Moderna dose on 1/7/21 & second dose on 2/6/21. immediately called the patient & left a voicemail asking the patient to call the pharmacy. The patient did not show up for her 1:15pm appointment, Rph called patient again leaving a second voicemail to call the pharmacy. As of 4:20pm on 8/22/21, patient has not showed up at the pharmacy & has not called the rph back. At this point, given the information listed in Immpact and not being able to ask the patient questions about how many covid-19 vaccines she received & why she noted that she had never received a dose, I am filing a report. It is not known if the patient has had any adverse reaction.


VAERS ID: 1617661 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 048C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Dysstasia, Gait disturbance, Malaise, Pain in extremity, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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: unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Sulfa antibiotics (headache, drowsy)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Days before patient could stand/walk on her own d/t pain in the feet and general unwell feeling. Slight fever. No appetite - unusual for patient.


VAERS ID: 1617701 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-20
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

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

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

Write-up: Moderna was administered to an unapproved 17 year old male patient. No adverse reports.


VAERS ID: 1620335 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Feeling of body temperature change, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: 102.7 F, Fever
CDC Split Type: USJNJFOC20210841938

Write-up: COLD THEN HOT; CHILLS; FEVER 102.7F; This spontaneous report received from a patient concerned a 25 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 18-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On AUG-2021, the patient experienced cold then hot. On AUG-2021, the patient experienced chills. On AUG-2021, the patient experienced fever 102.7f. Laboratory data included: Body temperature (NR: not provided) 102.7 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever 102.7f, chills and cold then hot was not reported. This report was non-serious.


VAERS ID: 1623351 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-20
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 3 LA / IM

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

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

Write-up: PATIENT SAID HER ARM BECAME RED AND SWOLLEN DOWN TO HER ELBOW.


VAERS ID: 1623386 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Fatigue, Headache, Hyperhidrosis, Illness, Influenza like illness, Lymphadenopathy, Nausea, Pain, Pharyngeal swelling, Pyrexia, Skin warm, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

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

Write-up: After I got the vaccine I got fatigued and nauseated in the first hour and had diarrhea.Then the aches started happening, horrible body aches that didn''t subside [ lasted 48 hours]. Then came the fever, chills, sweats, shakes and diziness. Then I got the worst pain of my life in the middle of my forehead, it hurt with every movement, every breath. My throat was swollen and lymph nodes and then the vomiting happened. This horrible head pain [felt like I got shot in the head], and vomiting continued for 6 hours straight. I was finally able to keep Benedryl down and it helped my throat otherwise I was going to call an ambulance. I was not in control of my body shaking, I was soaked and hot to the touch. The next day I still had aches and chills and some head pain. 2 days later I still feel like I am recovering, body is super sore and head is tender. [Feels now like a normal flu or sickness, not extreme like reaction]. I did not go to the ED in the beginning because having worked at the hospital, I did not want to feel that way being stuck there and during the worst part of it I honestly thought I was dying and did not even think about it but wish someone had taken me.


VAERS ID: 1623390 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Facial discomfort, Facial pain, Headache, Hypoaesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Hearing impairment (narrow), 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: He was not taking any medications.
Current Illness: No illnesses prior to vaccinations.
Preexisting Conditions: No chronic disease.
Allergies: Not allergic to any medications.
Diagnostic Lab Data: No medical studies at the moment, but planning to go to Medical later, as I mentioned in the previous part of the form.
CDC Split Type:

Write-up: Since getting the vaccine, I have headaches and a constant ringing in my right side of my face that causes discomfort and pain. On the right side of my face, I also feel pain and my face feels numb.


VAERS ID: 1623407 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bone anchored hearing aid implantation, Hallucination
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (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: Lisinopril for high blood pressure.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hallucinations and bionic hearing.


VAERS ID: 1623481 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-02
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Condition aggravated, Insomnia, Irritability, Migraine, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (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: Losartan Claritin-D Aspirin
Current Illness:
Preexisting Conditions: Hypertension, and optical migraines.
Allergies: None that I am aware. Some plant and animal allergies.
Diagnostic Lab Data: None Blood pressure checked.
CDC Split Type:

Write-up: Migraines Increased Blood Pressure (out of the ordinary, beyond usual or customary) Irritability (out of character) Insomnia Edema (out of the ordinary, beyond usual or customary


VAERS ID: 1623503 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-27
Onset:2021-08-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA67JE / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Oligomenorrhoea
SMQs:, Fertility disorders (broad)

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

Write-up: Missed period for 14 days when menstrual cycle is typically very regular


VAERS ID: 1623570 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-06
Onset:2021-08-01
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pneumonia, Respiratory failure, Sepsis
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

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

Write-up: Patient has respiratory failure with hypoxia, sepsis . Hospitalized due to pneumonia.


VAERS ID: 1623597 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-17
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Menstrual disorder, Migraine, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Norethin-Eth Estrad-Fe Biphas (LO LOESTRIN FE) 1 MG-10 MCG / 10 MCG TABS Omeprazole Magnesium (PRILOSEC OTC PO)
Current Illness: NA
Preexisting Conditions: Dysmenorrhea Anxiety Dyspareunia in female Vaginismus
Allergies: Azithromycin Ciprofloxacin Nausea Only Penicillins Hives
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient reported: Extreme nausea, migraine, and menstrual cycle activated (even though patient typically does not have a period).


VAERS ID: 1623721 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-19
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: Patient falsified birthdate on consent form in order to obtain vaccination prior to 12 years of age. Online insurance search matched with incorrect date of birth provided. Patient stated falsified birthdate during administration process.


VAERS ID: 1623757 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-28
Onset:2021-08-01
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Inhalers: Spiriva, Albuterol; Advair; Alendronate; Calcium; Lisinopril; Levoxyl, Mucinex, Miralax, Fish oil, Atorvastatin, Vitamin C
Current Illness: none
Preexisting Conditions: COPD; Hypertension, osteoporosis, seasonal allergies, stress incontinence, adenaomatous polyp of colon; history of colon cancer, pulmonary hypertension, major depression,
Allergies: penicillin, norvasc, gentamicin,
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever/chills/ cough/ fatigue starting on 8/16/21


VAERS ID: 1624001 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-08
Onset:2021-08-01
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood glucose increased, Blood ketone body increased, Diabetic ketoacidosis, Intensive care, Polyuria, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Tubulointerstitial diseases (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Patient had elevated blood sugar with elevated ketones in blood and was severely acidotic requiring Intensive Care treatment and ultimately education and treatment of Diabetes that he had no history of.
CDC Split Type:

Write-up: Patient, received second Pfizer Covid vaccination on July 8th, 2021. About August 1st, 2021, he started having symptoms of weakness, thirst and polyuria culminating in ICU hospitalization for Diabetic Ketoacidosis. He had no history of Diabetes prior to the Covid vaccine.


VAERS ID: 1624196 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / 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: on 04/07/2021, patient received J and J vaccine for COVID-19. On 08/19/2021, patient requested a dose for Moderna vaccine. Upon completing COVID screening form, he indicated he didn''t receive previous COVID-19 vaccine on intake form. Pharmacist was unaware patient had receive vaccine due to patient not reporting he received vaccine previously.


VAERS ID: 1624221 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-10
Onset:2021-08-01
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Dyspnoea, Fatigue, Insomnia, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin Oral (Tablet Delayed Release 81 mg) 1 tablet, daily. Atorvastatin Calcium Oral (Tablet 80 mg) 1 tablet, 3x a week. Azithromycin Oral. CARVEDILOL 3.125 MG Q AM. HYROXYUREA 500MG 1 Q PM AND ON M, W, F IN AM. methylPREDNISolone Oral
Current Illness: Hemorrhoids. Gastroesophageal Reflux Disease. Diverticulitis. Diabetes Mellitus. Congestive Heart Failure. Hypertension. Malignant Melanoma.
Preexisting Conditions: Hemorrhoids. Gastroesophageal Reflux Disease. Diverticulitis. Diabetes Mellitus. Congestive Heart Failure. Hypertension. Malignant Melanoma.
Allergies: Lactose Intolerance (GI)
Diagnostic Lab Data: Sars antigen (+) 8/1/2021
CDC Split Type:

Write-up: This is a 80-year-old Caucasian male who has multiple medical problems states that he was diagnosed with COVID-19 pneumonia in February of this year. He said that he got the J&J vaccine in April of this year. He said that 2 weeks later he started feeling short of breath and has been feeling short of breath off and on since then. He was admitted to this hospital in February of this year post Covid pneumonia for congestive heart failure. He has a history of medication noncompliance. He says that he could not sleep well at all last night. He says that he feels tired and fatigued all the time. He denies any history of fever chills nausea vomiting he came into the ER for evaluation where his BNP was elevated the ER physician requested to admit for congestive heart failure.


VAERS ID: 1624328 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-12
Onset:2021-08-01
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adverse drug reaction, Biopsy skin normal, Organ donor, Photosensitivity reaction, Rash
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (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: Estradiol, medroxyprogesterone, Effexor, Collagen, Tumeric, Krill oil
Current Illness: December 2020 had Covid, 1st covid vaccine 1/12/2021, 2nd 2/12 2021, no other illnesses.
Preexisting Conditions: NO other chronic illnesses. Donated a kidney May 19, 2021, complete workup prior to that negative.
Allergies: PCN mild
Diagnostic Lab Data: Biopsy as above. 2 rounds of steroids.
CDC Split Type:

Write-up: Developed a rash on my chest that has now spread over my entire body. Though to be pityiraiasis rosea but biopsy said not, though to be drug/photosensitive reaction.


VAERS ID: 1624348 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received COVID-19 (Pfizer) vaccine while still under the age of 12. Currently not recommended for her age group. Patient''s guardian gave false information (wrong date of birth) when filling out immunization consent form. Correct date of birth was verified by primary care provider and insurance.


VAERS ID: 1624550 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-23
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, No adverse event, Product preparation error
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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: Went to give an ob pt. Pfizer covid vaccine. Drew up 0.3mL. Gave pt vaccine. Pt had no reaction while in clinic. Pt is 19 weeks pregnant. When giving the vaccine diluent was not mixed in with it. Gave vaccine without diluent. Coworker notified me. Next step I filled an incident report


VAERS ID: 1625288 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-23
Onset:2021-08-01
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site erythema, Injection site swelling, Lymphadenopathy, Pain in extremity, Pruritus, Pyrexia, Rash macular, Skin test positive, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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: Tri lo estarylla - ortho tri cyclen lo (birth control)
Current Illness:
Preexisting Conditions: Diagnosed with CLL in late March. In watch and wait and no on treatment.
Allergies: Sulfa, amoxycillin, pencillin based drugs
Diagnostic Lab Data: My dermatologist''s office performed a dermography on my back -wooden q-tip stick and made a criss cross on my back and based on how my skin reacted they said it was hives. They prescribed me to take an over the counter anti histamine for six weeks -Allegra during day and Zyrtec at night. Unfortunately, there aren''t 12 hour doses available of each so they said i could take one or the other. I have been taking Zyrtec which has kept the hives from happening. However, when I stopped them after a week to see if they would come back, in 24 hours they returned -always at night- mostly on chest and neck. My doctors office said to keep taking the medicine. I skipped taking the Zyrtec one day due to a very bad headache and the hives returned within 24 hours and this time a bit on my chest but now on the right side of my lower cheek bone. I resumed taking the Zyrtec. Have about two weeks to go adn will check in with my doctor. I don''t think this issue is going to resolve after six weeks and I will likely need for doctor to bloodwork - that is what she said she would have to do if it didn''t resolve and will have to figure out next steps.
CDC Split Type:

Write-up: A week after the first shot which was on the left arm, I had a large red welt that looked like a giant bug bite. It resolved itself in a few days and wasn''t particularly worrisome or itchy. After the second shot on the RIGHT arm, the next day I immediately experienced the typical systems they say happens with Moderna, some fevering, chills, sore arm, redness/swelling at injection site and a golf ball size lymph node under the right arm. Symptoms resolved with in a few days except lymph node did take about two weeks to mostly go down. A week after the second shot, I expereinced some prickly like itching on my chest and neck more towards the same side as the injection site -on the right side of my body. Nothing on the left. Red splotches appeared. This went on for a couple of days and wasn''t resolving itself. It sort of got better with cold compresses and mitigated with benadryl cream but the issue persisted. I immediatley called a dermatologist and scheduled appointment.


VAERS ID: 1625956 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Anorexia
Preexisting Conditions: Comments: Patient was not pregnant and no breast feeding at the time of reporting.
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: 100.4 F
CDC Split Type: USJNJFOC20210843051

Write-up: FEVER; LIGHT HEADACHE; This spontaneous report received from a parent concerned a 25 year old female. The patient''s weight was 50 kilograms, and height was 170 centimeters. The patient''s concurrent conditions included: anorexia, and other pre-existing medical conditions included: Patient was not pregnant and no breast feeding at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286 expiry: UNKNOWN) dose was not reported, administered on 18-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced fever. On AUG-2021, the patient experienced light headache. Laboratory data included: Body temperature (NR: not provided) 100.4 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever, and the outcome of light headache was not reported. This report was non-serious.


VAERS ID: 1625974 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Fatigue, Injection site pain, Limb mass, Pain in extremity
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cardiomyopathy; Diabetic; Fibromyalgia
Preexisting Conditions: Medical History/Concurrent Conditions: Sickness; Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210844106

Write-up: LUMP IN THE ARM; RIGHT ARM IS SORE; PAIN IN SITE OF INJECTION; FATIGUE; LOSS OF ENERGY; This spontaneous report received from a patient concerned a 58 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: sick, and concurrent conditions included: fibromyalgia, diabetic, and cardiomyopathy, and other pre-existing medical conditions included: The patient had no known allergies. The patient experienced sick when treated with influenza vaccine. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 30-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced fatigue. On AUG-2021, the patient experienced loss of energy. On an unspecified date, the patient experienced lump in the arm, right arm is sore, and pain in site of injection. The action taken with covid-19 vaccine was not applicable. The patient recovered from lump in the arm, and pain in site of injection, and had not recovered from fatigue, loss of energy, and right arm is sore. This report was non-serious.


VAERS ID: 1625975 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Suspected COVID-19
SMQs:, Extravasation events (injections, infusions and implants) (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: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210844108

Write-up: HAVING COVID AGAIN TWO DAYS AFTER VACCINATION; ARM SORENESS TO THE TOUCH JUST AROUND THE INJECTION SPOT; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s past medical history included: covid-19. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on AUG-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 AUG-2021, the patient experienced having covid again two days after vaccination. On AUG-2021, the patient experienced arm soreness to the touch just around the injection spot. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from arm soreness to the touch just around the injection spot, and the outcome of having covid again two days after vaccination was not reported. This report was non-serious.


VAERS ID: 1628351 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2020-12-30
Onset:2021-08-01
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, Chest X-ray, Cough, Diarrhoea, Dyspnoea, Lacrimation increased, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Lacrimal disorders (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xyzal, Breo inhaler
Current Illness: Asthma and arthritis
Preexisting Conditions: Asthma
Allergies: Penicillin, tree nuts, scents, bleach, peanuts, black pepper
Diagnostic Lab Data: Chest X-ray 08/20/2021, covid test 08/20/2021
CDC Split Type:

Write-up: Fever, body aches, cough, diarrhea, loss of smell, congestion, shortness of breath, watery eyes, and runny nose. Prednisone 20mg 1 twice a day 9 tablets, cefuroxime 500mg 1 twice a day 10 tablets, azithromycin 500mg 1 tablet daily 3 tablets, Tylenol 500mg 2 tablets every 6 hours.


VAERS ID: 1628474 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol, triamterene, Women''s One a Day 50+, calcium, vitamin D, vitamin E, vitamin C, zync, vitamin A, Probiotic, magnesium
Current Illness:
Preexisting Conditions: Arthritis, high blood pressure, overweight
Allergies: Penicillin V Potassium, Adhesive, Codeine, Lisinopril
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Lymph nodes above the left collar bone and into neck on the left side started to swell during the night of August 1/morning of August 2nd. The area around the swelling was very sore the first few days. The swelling and soreness starting going down around August 6th. A rash was starting to appear in the same area around August 5th, and gradually got worse, peaking around August 8th, then started to get better on August 9th. The rash and swelling was completely gone by August 13th. Doctor looked at it on August 6th. No treatment was done, just waited it out until it was gone.


VAERS ID: 1628530 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Fever 101 Chills Severe Headache 11 hours first day. Nausea Diarrhea severe abdominal pain 2nd day


VAERS ID: 1628587 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chest pain, Muscle spasms, Nausea
SMQs:, Acute pancreatitis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (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: n/a
Current Illness: IBS
Preexisting Conditions: n/a
Allergies: zyrtec, walnut family, ragweed, lactose-intolerant (dairy triggers IBS flare up)
Diagnostic Lab Data:
CDC Split Type: n/a

Write-up: nausea a 2-3 days by day 5 post shot experience lung spasms or fluttering in chest (on and off for a week now) chest pain that has lasted approximately 8 days


VAERS ID: 1628640 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-24
Onset:2021-08-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, C-reactive protein normal, Pain, Pain in extremity, Pain of skin, Red blood cell sedimentation rate normal, Vitamin B12 normal
SMQs:, Peripheral neuropathy (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: Vit D
Current Illness: None
Preexisting Conditions: None
Allergies: Dust mites
Diagnostic Lab Data: Doctor ordered C reactive protein, vitamin B 12, ESR and RA marker and all was normal range. Blood collected on 8/19/2021
CDC Split Type:

Write-up: A week after second dose pain in Fingers in both hands especially around joints. Painful to grip things. Stinging pain sometimes on side of certain fingers. Two weeks later burning sensation in both hands intermittently and painful to the touch. It has been three weeks since I had this reaction and now I feel the burning sensation on tops of both feet. It is uncomfortable. I am also feeling the sensation in my arms now.


VAERS ID: 1628717 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-08-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oligomenorrhoea
SMQs:, Fertility disorders (broad)

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

Write-up: missed period


VAERS ID: 1628757 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 6780 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site bruising
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Patient has bruise on vaccination site for 3 weeks


VAERS ID: 1628857 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-02-15
Onset:2021-08-01
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 AR / IM

Administered by: Public       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: albuterol, citalopram, omeprazole, cetirizine, vitamin d
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Significant increase in tinnitus symptoms over the last several months. I have had to increase the amount of "white noise" (masking) in order to sleep.


VAERS ID: 1628880 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 2 LA / IM

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

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

Write-up: Patient stated that he had permanently lost sense of smell after the second dose. Stated he started the day after and has not returned. Denied that he has or had covid. Advised patient to seek medical care from primary care doctor, but stated he does not have primary care doctor and was not going to seek any additional care.


VAERS ID: 1631067 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dyspnoea, Fatigue, Feeling hot, Headache, Nausea, Neck pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (A glass of wine once a year); Non-smoker; Sulfonamide allergy
Preexisting Conditions: Comments: The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210843029

Write-up: LOSS OF APPETITE; NECK ACHE AT BASE; FELT HOT TO THE TOUCH; CHILLS; HEADACHE, IT WAS LIKE WHOLE HEAD HURT ALL OVER AND BACK OF HEAD; A LITTLE BIT OF NAUSEA FEELING; A LITTLE TIREDNESS BUT NOTHING EXTREME; SHORTNESS OF BREATH; This spontaneous report received from a patient concerned a 66 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: alcohol user, non smoker, and sulfa allergy, and other pre-existing medical conditions included: The patient had no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820095, and expiry: UNKNOWN) dose was not reported, administered on 16-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced shortness of breath. On 17-AUG-2021, the patient experienced loss of appetite. On 17-AUG-2021, the patient experienced neck ache at base. On 17-AUG-2021, the patient experienced felt hot to the touch. On 17-AUG-2021, the patient experienced chills. On 17-AUG-2021, the patient experienced headache, it was like whole head hurt all over and back of head. On 17-AUG-2021, the patient experienced a little bit of nausea feeling. On 17-AUG-2021, the patient experienced a little tiredness but nothing extreme. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from shortness of breath, loss of appetite, neck ache at base, chills, headache, it was like whole head hurt all over and back of head, a little bit of nausea feeling, and a little tiredness but nothing extreme on AUG-2021, and the outcome of felt hot to the touch was not reported. This report was non-serious.


VAERS ID: 1631077 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, General symptom, Injection site induration, Injection site pain, Rash
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), 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? 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: USJNJFOC20210844100

Write-up: LARGE, NICKEL TO QUARTER SIZED, HARDENED AREA UNDER THE SKIN ON LEFT ARM AT THE SITE OF INJECTION; BRUISING ON LEFT ARM; NORMAL SYMPTOMS; FEW RASHES ON LEFT ARM; PAINFUL TO TOUCH; This spontaneous report received from a consumer concerned a 26 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 14-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On AUG-2021, the patient experienced large, nickel to quarter sized, hardened area under the skin on left arm at the site of injection. On AUG-2021, the patient experienced bruising on left arm. On AUG-2021, the patient experienced normal symptoms. On AUG-2021, the patient experienced few rashes on left arm. On AUG-2021, the patient experienced painful to touch. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from large, nickel to quarter sized, hardened area under the skin on left arm at the site of injection, painful to touch, few rashes on left arm, and bruising on left arm, and the outcome of normal symptoms was not reported. This report was non-serious.


VAERS ID: 1631089 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Idaho  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Emotional distress, Headache
SMQs:, Depression (excl suicide and self injury) (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: USJNJFOC20210846286

Write-up: PERSISTENT HEADACHE PAIN; AUDIBLY DISTRESSED; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On AUG-2021, the patient experienced audibly distressed. On 18-AUG-2021, the patient experienced persistent headache pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from persistent headache pain, and the outcome of audibly distressed was not reported. This report was non-serious.


VAERS ID: 1631090 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bedridden, Body temperature, Bruxism, Chills, Insomnia, Pruritus, Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient was healthy and didn''t change anything in diet or anything other than the vaccine.
Allergies:
Diagnostic Lab Data: Test Date: 20210809; Test Name: Body temperature; Result Unstructured Data: 102
CDC Split Type: USJNJFOC20210846321

Write-up: WAS IN BED THE WHOLE DAY; TEETH SHATTERING; CHILLS/SHIVERS; FEVER; PREVENTING FROM SLEEP; ITCHING (PREVENTING HER FROM SLEEP); RASH; GET BUMPS EVERYWHERE; This spontaneous report received from a patient concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient was healthy and didn''t change anything in diet or anything other than the vaccine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821281, expiry: UNKNOWN) dose was not reported, administered on 08-AUG-2021 18:00 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced preventing from sleep. On AUG-2021, the patient experienced itching (preventing her from sleep). On AUG-2021, the patient experienced rash. On AUG-2021, the patient experienced get bumps everywhere. On 08-AUG-2021, the patient experienced teeth shattering. On 08-AUG-2021, the patient experienced chills/shivers. On 08-AUG-2021, the patient experienced fever. On 09-AUG-2021, the patient experienced was in bed the whole day. Laboratory data included: Body temperature (NR: not provided) 102. On 22-AUG-2021, treatment medications included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from teeth shattering, chills/shivers, and fever on 09-AUG-2021, was recovering from itching (preventing her from sleep), had not recovered from rash, and the outcome of get bumps everywhere, was in bed the whole day and preventing from sleep was not reported. This report was non-serious.


VAERS ID: 1631091 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Adverse event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210846337

Write-up: SYMPTOMS AFTER RECEIVING VACCINE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on AUG-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On AUG-2021, the patient experienced symptoms after receiving vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of symptoms after receiving vaccine was not reported. This report was non-serious.


VAERS ID: 1631107 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210846833

Write-up: CHILLS; HEADACHE; NAUSEA; 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: Unknown) dose was not reported, administered on 10-AUG-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 AUG-2021, the patient experienced chills. On AUG-2021, the patient experienced headache. On AUG-2021, the patient experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, nausea and chills was not reported. This report was non-serious.


VAERS ID: 1632599 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-11
Onset:2021-08-01
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bladder pain, Chills, Decreased appetite, Fatigue, Headache, Infection, Influenza like illness, Pain, Respiratory disorder, Spinal pain, Urinary bladder haemorrhage, Urine analysis abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (broad), Arthritis (broad), Respiratory failure (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: Rosuvastatin; metformin; aspirin; B12; magnesium; omega 3
Current Illness: None
Preexisting Conditions: Sinus infections; Diabetes; high cholesterol
Allergies: None
Diagnostic Lab Data: Urine test positive infection
CDC Split Type: vsafe

Write-up: After each shot, I had a headache, flu like symptoms, chills, I was tired. No desire to eat. I was having urinary bladder bleeding and pain. Like a urine infection, however it was negative. Headaches. My entire spine was in pain. Achiness all over. Sinus respiratory issues. I contacted my doctor and he tried to give an antibiotic for what he thought was a urine infection. There was no urine infection, just an infection. Now I am seeing a urology, but we do not know what it is yet.


VAERS ID: 1632721 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-25
Onset:2021-08-01
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Chest pain, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), 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? 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: Patient hospitalized due to COVID-19. Patient is fully vaccinated. He complained of chest pain and had an MI.


VAERS ID: 1632769 (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: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: no
Preexisting Conditions: none
Allergies: penicillin Cephalexin Sulfa
Diagnostic Lab Data: I have an audiology test on September 3
CDC Split Type:

Write-up: A few days after I received my vaccine, I developed tinnitus. Mainly in both ears, but a higher tone in my right ear. I never had tinnitus prior to the vaccine.


VAERS ID: 1632846 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-08-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Fatigue, Headache, Injection site pain, Pain, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi Vitamin Low dose blood pressure med
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Called my physician to discuss with him. He suggested testing for Covid19, test result (tested 11 days after vaccine) was negative.
CDC Split Type:

Write-up: Alarming tightness in chest for 3 days, difficulty breathing. Other symptoms, extreme fatigue, soreness at injection site for 5 days, headache for 10 days, body ache 7 days.


VAERS ID: 1632981 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-08-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0578 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA9099 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility disorders (broad)

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

Write-up: Menstruation cycle began early - on day 10 post vaccine - and lasted twice as long as normal. I have not had another period since; time will tell if I do. I''ve been very regular, historically.


VAERS ID: 1633015 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-22
Onset:2021-08-01
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Influenza virus test negative, Lymphadenopathy, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shringrix vaccine- I get flu like symptoms
Other Medications:
Current Illness:
Preexisting Conditions: Rheumatoid Arthritis; Type II diabetes; elevated cholesterol; elevated high blood pressure
Allergies: Walnuts; cantaloupe; mangos; seasonal allergies to trees and grass
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: About 4 weeks ago, I started to have swollen glands, a sore throat, fever of 99.3 and 101.F lasting two full weeks. I went to get tested and had a negative strep test, flu test and COVID test. These tests were done at an ER. I work in a clinic and someone also at my office had this kind of virus, symptoms and she also tested negative for COVID. I have recovered from my symptoms.


VAERS ID: 1633135 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-23
Onset:2021-08-01
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 09D21A / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Heart rate irregular
SMQs:, Anaphylactic reaction (broad), Cardiac arrhythmia terms, nonspecific (narrow)

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

Write-up: Tightness of chest and heart area, irregular heart beat.


VAERS ID: 1633623 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-03
Onset:2021-08-01
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 2 UN / UN

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

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

Write-up: Patient admitted to hospital with COVID positive test despite full vaccination status in Feb 2021


VAERS ID: 1633812 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Burning sensation, Chills, Diarrhoea, Dizziness, Erythema, Feeling hot, Headache, Hyperhidrosis, Impaired work ability, Malaise, Nausea, Pain, Presyncope, Pyrexia, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Nausea, vomiting, dizzy, diaphoretic, fever, chills, abdominal pain, diarrehea , hot burning in left arm, redness left arm, severe headache pain, shakey , felt like I was going to pass out. sick 4 days missed one night of work . I felt severely ill and in pain.


VAERS ID: 1634858 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Contusion, Erythema, Feeling hot, Headache, Hyperaesthesia, Hyperhidrosis, Myalgia, Pain, Pain in extremity, Pyrexia, Thrombosis, Varicose vein, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies. The patient did not have any history of drug abuse or illicit drug use. The patient had no medical history to share and was generally in good health.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210844617

Write-up: BLURRED VISION; POTENTIAL BRUISE; CONCERNED ABOUT A BLOOD CLOT; BODY PAIN IN DIFFERENT AREAS; RIGHT UPPER LEG MORE SENSITIVE; POTENTIAL REDNESS ON SKIN OF LEG; LOT OF PAIN BEHIND RIGHT LEG MOSTLY FROM THE KNEE UP BUT LITTLE BELOW THE KNEE ALMOST TO THE TOP OF THE LEG (MOSTLY IN THE MIDDLE OF THE UPPER LEG); CHILLS, SHIVERING; HEADACHE; MUSCLE AND BODY ACHES; SWEATY; LOW GRADE FEVER; VARICOSE VEINS AT BACK OF LEG TURNED MORE BLUE AND MIGHT BE LITTLE RED; HOT ON AND OFF; This spontaneous report received from a patient concerned a 46 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: non alcohol user, and non smoker. The patient had no known allergies. The patient did not have any history of drug abuse or illicit drug use. The patient had no medical history to share and was generally in good health. The patient was not pregnant at the time of report. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, 1 total, administered on left arm on 20-AUG-2021 15:50 for prophylactic vaccination. No concomitant medications were reported. On 21-AUG-2021, twelve hours after vaccination, like clockwork, the patient woke up at 3 AM shivering and had various body pain in different areas. By morning time, when she got up she felt that area (right upper leg) was more sensitive and then on the morning of 22-AUG-2021, it was much worse instead of getting better. On 21-AUG-2021, the patient had a headache, muscle and body aches, lot of pain behind right leg, mostly from the knee up but starting a little below the knee almost to the top of the leg, mostly in the middle of the upper leg and potential redness on skin of leg. The pain was like a bruise, it felt like she was touching a bruise when she was not (potential bruise). She was unable to confirm the appearance of the back of leg when questioned if there was a visible bruise. She was also unable to confirm if there was any swelling or heat present in the affected area. When she tried to see the back of leg she had varicose veins which had turned more blue and it might turned a little red back there. She was concerned about a blood clot as she read about that being a potential with the Janssen COVID-19 vaccine. She had chills and got sweaty. In AUG-2021, the patient felt like she had a low grade fever in general but she did not have a thermometer to measure. The patient was hot on and off. Her usual or expected side effects such as shivering, fever, various pains in other areas and headache went away. On 22-AUG-2021, her vision was blurred, she couldn''t drive without glasses and usually she did not bother putting them on. The patient visited emergency room and physician''s office. She did not know if this was related to the vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sweaty, body pain in different areas, chills, shivering, low grade fever, and headache on AUG-2021, had not recovered from lot of pain behind right leg mostly from the knee up but little below the knee almost to the top of the leg (mostly in the middle of the upper leg), muscle and body aches, right upper leg more sensitive, and concerned about a blood clot, and the outcome of blurred vision, potential bruise, hot on and off, potential redness on skin of leg and varicose veins at back of leg turned more blue and might be little red was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: Medical assessment comments not required as per the standard procedure as the case is assessed as non-serious.


VAERS ID: 1634861 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Body temperature, Chills, Malaise, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 20210810; Test Name: Body temperature; Result Unstructured Data: 39 C
CDC Split Type: USJNJFOC20210845308

Write-up: TINGLING PRICKLY FEELING IN HANDS; SHIVERS; DIDN''T FEEL TOO WELL; FEVER OF 39 DEGREES; WEAK; This spontaneous report received from a consumer concerned a female of unspecified age. 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, and batch number were not reported) dose was not reported, administered on 10-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On AUG-2021, the patient experienced weak. On 10-AUG-2021, the patient experienced tingling prickly feeling in hands. On 10-AUG-2021, the patient experienced shivers. On 10-AUG-2021, the patient experienced didn''t feel too well. On 10-AUG-2021, the patient experienced fever of 39 degrees. Laboratory data included: Body temperature (NR: not provided) 39 C. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from weak, and the outcome of tingling prickly feeling in hands, fever of 39 degrees, shivers and didn''t feel too well was not reported. This report was non-serious. This case, from the same reporter is linked to 20210850476.


VAERS ID: 1634863 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210822; Test Name: COVID-19 virus test; Result Unstructured Data: Positive.
CDC Split Type: USJNJFOC20210846287

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 50 year old white not Hispanic or Latino female. Initial information was processed along with the additional information received on 24-AUG-2021. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, and expiry: 18-SEP-2021) dose was not reported, 1 total administered to the left arm on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced symptoms of Covid (headache, congestion, exhausted, things taste funny, runny nose). On 22-AUG-2021, patient received a result of COVID-19 virus test positive. The symptoms started last week but patient did not realize she had been infected (suspected covid-19 infection and suspected clinical vaccination failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000190597.; Sender''s Comments: V0 20210846287- COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1634866 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Eye irritation, Fatigue, Hyperhidrosis, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Corneal 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: LORTAB [LORATADINE]
Current Illness: Abstains from alcohol; Epstein-Barr virus infection; Hashimoto''s disease; Non-smoker; Palpitations; Penicillin allergy; Sinusitis; Thyroid nodule
Preexisting Conditions: Comments: The patient had no drug abuse or illicit use.
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: 99-100 Fahrenheit
CDC Split Type: USJNJFOC20210846423

Write-up: ACHY; SWEATY; BURNING BEHIND THE EYES; LOW GRADE FEVER; SORE AT INJECTION SITE; FATIGUE; This spontaneous report received from a patient concerned a 69 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: sinusitis, penicillin allergy, hashimoto''s, epstein barr, minor palpitations, non alcohol user, non smoker, and thyroid nodule, and other pre-existing medical conditions included: The patient had no drug abuse or illicit use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: UNKNOWN) dose was not reported, administered on 20-AUG-2021 for prophylactic vaccination. Concomitant medications included loratadine. On AUG-2021, the patient experienced achy. On AUG-2021, the patient experienced sweaty. On AUG-2021, the patient experienced burning behind the eyes. On AUG-2021, the patient experienced low grade fever. On AUG-2021, the patient experienced sore at injection site. On AUG-2021, the patient experienced fatigue. Laboratory data included: Body temperature (NR: not provided) 99-100 Fahrenheit. Treatment medications (dates unspecified) included: vitamins nos, and paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from sore at injection site, and had not recovered from low grade fever, fatigue, burning behind the eyes, sweaty, and achy. This report was non-serious.


VAERS ID: 1634872 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac stress test, Chest X-ray, Chest discomfort, Chills, Computerised tomogram, Dyspnoea, Electrocardiogram, Fibrin D dimer, Headache, Heart rate, Hyperhidrosis, Injection site pain, Myalgia, Oxygen saturation, Oxygen saturation decreased, Pain in extremity, Pyrexia, SARS-CoV-2 test, Troponin, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Bronchitis (The patient had a chest infection and ended up with bronchitis in her late 30s and was treated with Albuterol.); Chest infection; Short of breath (When the patient was a teenager and was active in sports sometimes would get short of breath and was treated with nebulizer.); Comments: The patient had no known prior history and did not have any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: negative; Test Date: 202108; Test Name: Troponin; Result Unstructured Data: negative; Test Date: 202108; Test Name: CT scan; Result Unstructured Data: negative; Comments: 2 times; Test Date: 202108; Test Name: EKG; Result Unstructured Data: negative; Comments: 5 times; Test Date: 202108; Test Name: Fibrin D dimer; Result Unstructured Data: negative; Test Date: 202108; Test Name: Chest X-ray; Result Unstructured Data: negative; Comments: 2 times; Test Date: 202108; Test Name: Stress test; Result Unstructured Data: negative; Test Date: 202108; Test Name: Oxygen saturation; Result Unstructured Data: 100 but with movement it goes down to 70-80%; Test Date: 202108; Test Name: Heart rate; Result Unstructured Data: 100; Test Date: 202108; Test Name: Diagnostic ultrasound; Result Unstructured Data: negative; Comments: Did ultrasound for the possibility of fluid around the lung which was negative.
CDC Split Type: USJNJFOC20210846641

Write-up: CHRONIC CHEST TIGHTNESS; LABORED BREATHING UPON MOVEMENT; WITH MOVEMENT OXYGEN LEVEL WENT DOWN TO 70 TO 80 PERCENTAGE; SWEATS; CHILLS; SORE ARM FOR 1 WEEK; BURNED INTENSELY AT THE TIME OF INJECTION; HEADACHE; MUSCLE ACHES ALL OVER THE BODY; LOW GRADE FEVER; This spontaneous report received from a patient concerned a 47 year old female. The patient''s weight was 155 pounds, and height was 67 inches. The patient''s past medical history included chest infection and ended up with bronchitis in her late 30s. When the patient was a teenager and was active in sports sometimes would get short of breath. The patient''s concurrent conditions included non smoker, and abstains from alcohol, and other pre-existing medical conditions included no known prior history and did not have any drug abuse/illicit drug use. The patient was previously treated with salbutamol for bronchitis and with nebulizer for short of breath. The patient experienced hives all over body when treated with amoxicillin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 201A21A expiry: 21-SEP-2021) dose was not reported, 1 total, administered on 09-AUG-2021 at around 15:30 to left arm for prophylactic vaccination. No concomitant medications were reported. On 09-AUG-2021, the patient experienced intense burning at the time of injection and had sore arms for one week. Half an hour later the patient had a headache and 2 hours later had muscle aches all over her body, low grade fever, chills and sweating which all were resolved in morning after 48 hours. The next morning on 10-AUG-2021 the patient felt tight chest, something that had not gone away and she had chronic chest tightness and labored breathing. The patient visited ER (emergency room) twice. On 14-AUG-2021, the patient visited ER for second time and got admitted. The patient underwent lab tests such as blood clots (negative for pulmonary embolism), troponin, D-Dimer, COVID (rapid tests), 5 times EKGs (electrocardiogram), 2 times CT (computerised tomogram) scans, 2 times chest X-Rays, Stress test with lexiscan (because the patient could not perform on treadmill) and they all were negative. They ruled out myocarditis or pericarditis and did ultrasound for the possibility of fluid around the lung which was negative. They found mitral valve thickening which were told it was not significant. They also pointed out to anxiety but the reporter said that she knew that was not anxiety. The patient''s main concern was that she had labored breathing with any movement or positioning and she had chronic chest tightness that she said she had been in intermittent ambulatory distress. The patient''s oxygen level at rest was 100 but with movement oxygen level went down to 70 to 80 percentage and her heart rate went up to 100. They treated her with IV (intravenous) saline drip on the first day in the hospital and nothing was given orally for the tests. They offered heparin and steroids but the patient declined. She will also be seen by a pulmonary specialist. At the time of reporting the patient was in the hospital. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sweats, chills, headache, muscle aches all over the body, and low grade fever on 11-AUG-2021, and sore arm for 1 week, and burned intensely at the time of injection on 16-AUG-2021, had not recovered from chronic chest tightness, and labored breathing upon movement, and the outcome of with movement oxygen level went down to 70 to 80 percentage was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210846641 -covid-19 vaccine ad26.cov2.s- chronic chest tightness, labored breathing upon movement, with movement oxygen level went down to 70 to 80 percentage. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1634874 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Body temperature, Fatigue, Feeling cold, Headache, Injection site pain, Malaise, Nausea, Pain in extremity, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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:
Current Illness: Migraine
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Body temperature; Result Unstructured Data: 100.8 F
CDC Split Type: USJNJFOC20210846881

Write-up: FATIGUE(TIREDNESS); PAIN AT INJECTION SITE/ARM; NAUSEA; FEVER/CHILLS,FEVER OF 100.8F; SEVERE HEADACHE; FEELS BLOATED WITH ABDOMINAL DISTENTION; SHAKING/TREMBLING; FEELING COLD; FEELING SICK ,UNWELL,DID NOT FEEL WELL, GENERAL MALAISE; VOMITING,RETCHING; ARM WAS VERY PAINFUL; This spontaneous report received from a patient concerned a 65 year old female. The patient''s weight was 120 pounds, and height was 65 inches. The patient''s concurrent conditions included: occasional migraines. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 14-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced arm was very painful. On 14-AUG-2021, the patient experienced feels bloated with abdominal distention. On 14-AUG-2021, the patient experienced shaking/trembling. On 14-AUG-2021, the patient experienced feeling cold. On 14-AUG-2021, the patient experienced feeling sick, unwell, did not feel well, general malaise. On 14-AUG-2021, the patient experienced vomiting, retching. On 14-AUG-2021, the patient experienced nausea. On 14-AUG-2021, the patient experienced fever/chills, fever of 100.8f. On 14-AUG-2021, the patient experienced severe headache. On 14-AUG-2021, the patient experienced pain at injection site/arm. Laboratory data included: Body temperature (NR: not provided) 100.8 F. On 15-AUG-2021, the patient experienced fatigue (tiredness). Treatment medications (dates unspecified) included: naproxen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from shaking/trembling, feeling cold, vomiting,retching, nausea, fever/chills,fever of 100.8f, and severe headache on 15-AUG-2021, and arm was very painful, and pain at injection site/arm on AUG-2021, and had not recovered from fatigue(tiredness), feeling sick ,unwell,did not feel well, general malaise, and feels bloated with abdominal distention. This report was non-serious.


VAERS ID: 1636144 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Dyspnoea, Hypertension, Influenza like illness, Injection site nodule, Rash erythematous, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Penicillin allergy; Sulfonamide allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Blood pressure; Result Unstructured Data: 190/120 mmHg; Comments: high
CDC Split Type: USJNJFOC20210849527

Write-up: THROAT HAS CLOSED; DIFFICULTY BREATHING; FULL BODY RASH BRIGHT RED AND PUFFY (LIKE A BAD CASE OF POISON IVY); FLU-LIKE SYMPTOMS; KNOT AT INJECTION SITE; HIGH BLOOD PRESSURE; This spontaneous report received from a consumer concerned a 42 year old female of unspecified ethnic origin and race. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: sulfa allergy, and penicillin allergy. The patient was not pregnant at the time of report. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A and expiry: UNKNOWN) dose was not reported, administered on 19-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-AUG-2021, the patient experienced flu-like symptoms, headache and fever. On 20-AUG-2021, the patient experienced full body rash bright red and puffy (like a bad case of poison ivy). On 22-AUG-2021, the patient experienced throat has closed and difficulty breathing On AUG-2021, the patient experienced knot at injection site and high blood pressure Laboratory data included: Blood pressure (NR: not provided) 190/120 mmHg. The patient visited hospital and visited emergency room (8 times). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the full body rash bright red and puffy (like a bad case of poison ivy), difficulty breathing, high blood pressure, knot at injection site, flu-like symptoms and throat has closed was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210849527-Covid-19 vaccine ad26.cov2.s- High blood pressure. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1636146 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Oregon  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Diplopia, Feeling abnormal, Headache, Impaired driving ability, Mental disorder, Pain in extremity
SMQs:, Dementia (broad), Ocular motility disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Occasionally); Migraine (Rare); Poison oak rash; Smoker (Chewing tobacco)
Preexisting Conditions: Comments: The patient was very healthy. The patient have no history of drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210851632

Write-up: PAIN IN CALF AND CHECKED CALF AND SAW A LONG DARK VEIN (DESCRIBED IT AS ONE LONG VEIN 80% OF HIS CALF); HEADACHES (DESCRIBED THEM AS HEAVINESS AND FULLNESS); DOUBLE VISION (COULD NOT READ SUBTITLES WHEN WATCHING A MOVIE); MENTALLY OFF CAN NOT PROCESS; FEELS WEIRD; COULD NOT DRIVE HOME; This spontaneous report received from a consumer concerned a 36 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: migraines, poison oak allergy, alcohol user, and smoker, and other pre-existing medical conditions included: The patient was very healthy. The patient have no history of drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: UNKNOWN) dose was not reported, administered on 21-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, the patient experienced double vision (could not read subtitles when watching a movie). On AUG-2021, the patient experienced mentally off can not process. On AUG-2021, the patient experienced feels weird. On AUG-2021, the patient experienced could not drive home. On AUG-2021, the patient experienced headaches (described them as heaviness and fullness). Treatment medications included: paracetamol. On 23-AUG-2021, the patient experienced pain in calf and checked calf and saw a long dark vein (described it as one long vein 80% of his calf). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headaches (described them as heaviness and fullness), and the outcome of double vision (could not read subtitles when watching a movie), mentally off can not process, feels weird, pain in calf and checked calf and saw a long dark vein (described it as one long vein 80% of his calf) and could not drive home was not reported. This report was non-serious.


VAERS ID: 1636391 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-30
Onset:2021-08-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Headache, Lymphadenopathy, Myalgia, Oral herpes
SMQs:, Rhabdomyolysis/myopathy (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Verapamil, Prilosec, Vitamin D
Current Illness: None
Preexisting Conditions: SVT
Allergies: Nortriptyline
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Swollen lymph gland in left armpit (same side as injection) muscle/body aches, Cold sores, headache for approximately for 1 week after injection.


VAERS ID: 1636418 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-26
Onset:2021-08-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Furuncle, Headache, Heart rate increased, Hyperhidrosis, Hypotension, Lymph node pain, Lymphadenopathy, Night sweats, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine, Vitamin D, Vitamin C, multi- vitamin
Current Illness: none
Preexisting Conditions: Celiac, Hypothyroidism, various autoimmune conditions
Allergies: hydroxychloroquine,Mycophenolate, gluten (Celiac)
Diagnostic Lab Data: I had a multitude of medical tests during my hospital stay.
CDC Split Type:

Write-up: My first week after the vaccine, I had what I would have considered typical side effects. I had some fatigue, headaches, a sore underarm lymph node, and I had a boil appear on my back. At this point, I was able to take ibuprofen for headaches as needed and go about my day. In the second week, the side effects increased in intensity. The underarm lymph nodes increased in size, I started to get more boils, I was getting some lower grade fevers and struggling to push through my regular day. By the end of the second week, Tuesday August 10th, in evening I had a temp of 102.5, was freezing and taking ibuprofen every 4 hours to keep headaches, and fever at bay. Every time the ibuprofen ran out, my fever went back up and I was soaking sweat through my clothes multiple times a day and night. After a couple of days of this my fevers kept increasing, boils kept popping up (which I have never had before) and my lymph node was huge. I started adding acetaminophen to the ibuprofen routine to try to keep fevers down and was messaging my dr at this point. By Friday at 5:00, my temp was 103.5 and all side effects were increasing. My husband took me to urgent care where they treated me and told me not to get worse. I was home for a short time that evening when the fever came back. I ended up in the emergency room and the Drs there admitted me to the hospital. In addition, at this point, I had increased heart rate and low blood pressure as well. I was released late Tuesday afternoon August 17th.


VAERS ID: 1636610 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-01
Onset:2021-08-01
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

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

Write-up: unknown


VAERS ID: 1636683 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-01
Onset:2021-08-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac arrest, Condition aggravated, Pulmonary embolism, Respiratory failure
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: h/o antiphospholipid syndrome and PE in the past
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: massive Pulmonary embolism leading to cardiac arrest and respiratory failure


VAERS ID: 1636814 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-22
Onset:2021-08-01
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Headache, Pyrexia, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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

Write-up: Fever, headaches, abd pain.


VAERS ID: 1636831 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-15
Onset:2021-08-01
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Nasal congestion, Pain, Rhinorrhoea, SARS-CoV-2 test
SMQs:, COVID-19 (broad)

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

Write-up: Rhinorrhea, nasal congestion, body aches.


VAERS ID: 1636864 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-10
Onset:2021-08-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Headache, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

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

Write-up: headache, cough.


VAERS ID: 1636907 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-23
Onset:2021-08-01
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Rhinorrhoea, SARS-CoV-2 test
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Aortic insufficiency, AV block, CAD, DM, Hypercholestrolemia, HTN, thyroid disease.
Allergies: Aspirin, plavix
Diagnostic Lab Data: Covid test
CDC Split Type:

Write-up: Rhinorrhea, covid exposure.


VAERS ID: 1637258 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-29
Onset:2021-08-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient states that, she experienced severe pains at the injection site 3 days after receiving her 2nd shot of COVID-19 vaccine. She states that she took some over the counter pain medications and antihistamines, she also had acupuncture do
Current Illness: She states that she did not have any illness at the time of vaccination.
Preexisting Conditions: She states that she does not have any chronic or long-standing health conditions.
Allergies: She states that she does not have any allergies.
Diagnostic Lab Data: She stated that she had not had any medical tests or laboratory tests done in relation to the adverse event. However, she states that she visited her doctor who told her it could probably be a case of improper administration of the vaccine.
CDC Split Type:

Write-up: Patient called and stated that she is experiencing severe pains at the site of injection which started 3 days after the vaccine administration. She states that she has taken some over the counter antihistamines and pain medications. she stated that she also had acupuncture done twice in an attempt to relief the pain.


VAERS ID: 1637606 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-01
Onset:2021-08-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Cardiovascular symptom, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: 37 y/o/m without any medical history presented 2 days after vaccine with cardiac complaints. Found lying on boat dock extremely diaphoretic, pale, and weak, complaining of cardiac symptoms. Transported to ER.


VAERS ID: 1637826 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-02
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Myalgia, Pain, Pain in extremity, Paraesthesia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: HTN, Hyperlipidemia, CAD, Type 2 diabetes, Overweight, Smoker
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports that since he received his second Pfizer COVID-19 vaccine in his left arm on 8/2/21, he has had left arm pain and tingling down to his fingers and radiating to his neck. He states this pain began 3-4 days after the injection. He denies any CP or SOB. He states that it feels like severe muscle pain and it keeps him awake at night. He reports the pain is causing him problems with his everyday movements and activities. Denies redness or swelling. He states he has tried cold compresses, heat application, NSAIDs, and Tylenol with no effect. He did not have a reaction with the first vaccine.


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