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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 316 out of 7,116

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VAERS ID: 1518594 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-23
Onset:2021-07-31
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Differential white blood cell count, Full blood count, Movement disorder, Near drowning, Platelet count, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot and DPT on Nov 2020 had a vaso vagus right after shots
Other Medications: Clonazepam 0..5, temazepam 15mg , Linzess 145mg, Zoloft 50mg, Fish oil (Wileys finest Wild Alaskan), Solgar Calcium magnesium with Vitamin d3, Condemned laborat ortez Arsyn
Current Illness: No.
Preexisting Conditions: adult chronic mild ITP
Allergies: sulfa, ethyl acrylate,methyl methacrylate
Diagnostic Lab Data: None, This happened today. I am home keeping an eye on me. . I did have a CBC with a diff on Wednesday to make sure my platelet count was fine after taking the vaccine. I had my hemonc order it. On monday i am calling my cardiologist (right branch bundle block)
CDC Split Type:

Write-up: Today I jumped in pool at 5 feet and started to swim towards the stairs. When I went to catch my breath as I am too lazy to pop up my head,after each stroke, at around 4 feet I popped up my head and could not feel the bottom of the pool. I found myself drowning. It happened so sudden and lasted like 5-8 seconds. One second I was swimming and the next I was like in a dream where the water was going into my throat, my body wasn''t moving. My mouth wasn''t closing. All i know was I could hear these sounds coming from my throat like when you are dreaming and want someone to wake you up. I was aware I was drowning but didn''t know why or how. Suddenly I snapped out of it and stood up and walked to the stairs. I was confused on what had just happened to me because it seemed like I had woken up from a nightmare. There were two ladies sitting by the pool. i asked them if I had been making weird sounds and they said yes. The one lady said she was ready to get up and jump into the pool when she then saw me get up and walk.


VAERS ID: 1518595 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK LA / IM

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

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

Write-up: Pt received the vaccine and after roughly 3 or 4 minutes later fainted.


VAERS ID: 1518596 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive PCR test for COVID-19 on 7/31/2021
CDC Split Type:

Write-up: Patient required hospitalization for COVID-19 after being fully vaccinated


VAERS ID: 1518599 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Hypotension, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Pt felt dizzy after receiving her shot. She also was pale and her blood pressure was low (diastolic in the 50''s 5 minutes post-imz and 105/73 10 minutes post-imz). Pt was given a cold pack to place on her neck and she sat until she felt well enough to leave.


VAERS ID: 1518600 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Sensation of foreign body
SMQs:, Anaphylactic reaction (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: Shellfish and penicillin (hives/throat closing)
Diagnostic Lab Data: Blood pressure and pulse were 142/90 and 64 4:37 pm on 7/31/2021. Rechecked at 4:44 and BP was 133/85.
CDC Split Type:

Write-up: Patient received vaccine at 3:04 pm 7/31/2021. At 3:30 pm pharmacist was notified that patient was experiencing a knot in the throat (similar to when he consumes shellfish). Patient could still talk and breath normally with no outward signs of distress. Patient was given 10 ml of Diphenhydramine and monitored for the next hour by the pharmacist. Patient reported the knot going away within 5 to 10 minutes of diphenhydramine being administered. No itching or hives or dizziness experienced by patient. Patient did not report any tongue swelling or throat closure. Blood pressure and pulse were 142/90 and 64 4:37 pm on 7/31/2021. Rechecked at 4:44 and BP was 133/85.


VAERS ID: 1518601 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / IM

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

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

Write-up: Patient was sitting in the waiting area for 15 minutes after her immunization. During this time she passed out and her mom caught her before she slid into the floor. She was given a sprite to drink and was fanned to cool her off. She was clammy and pale. She started to pass our again and was placed in the floor with her legs elevated. She began feeling better and was taken to her mother''s vehicle in the store''s wheelchair. Mother will continue to monitor at home.


VAERS ID: 1518605 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
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: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt initially received Moderna 007C21A on 5/17/21 and today 7/31/21 was given Pfizer EW0217 due to vaccine availability at the event and pt status. Pt insisted and verbally gave consent in getting Pfizer vaccine today despite given the option to receive same vaccine as first dose in a different clinic and different date/times.


VAERS ID: 1518607 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Pallor, Presyncope
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: pt was provided a pfizer covid 19 vaccination and become nauseous and light headed afterword, presented with syncope symptoms but didn''t fully lose consciousness pt was given ice packs to back of neck, an emesis bag was provided pt never had vomitous, pulse was strong throughout. Pt was placed in a supine position with legs elevated, and we used alcohol pads as a smelling salt. After aproximately 15 minutes pts color returned she was coherent and talking and stated she was feeling fine. Pt has history of fainting with all vaccines per her uncle (a registered nurse) who was present with the patient through out the entire process start to finish. Will file an SCRT and Vaers report for this incidence.


VAERS ID: 1518608 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Dizziness and vomiting


VAERS ID: 1518610 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Loss of consciousness, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no know
Preexisting Conditions: none
Allergies: no known
Diagnostic Lab Data: blood pressure 105/50
CDC Split Type:

Write-up: Within 2 minutes of receiving vaccine, pt passed out, shaking, unresponsive, sweating.. Unresponsive lasted about 20 seconds. after awaking, blood pressure was 105/50. called 911, pt was evaluated by emergency response team and released


VAERS ID: 1518612 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Public       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: none
CDC Split Type:

Write-up: Patient came in for 2nd dose Pfizer covid vaccine and was administered on day 16 instead of the earliest indicated day 17. Pt informed of error, side effects reviewed and questions answered and pt verbalized understanding of teaching.


VAERS ID: 1518615 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

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

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

Write-up: Approximately 5 minutes after receiving Pfizer COVID vaccination, patient stated that she felt "drugged" and that she was having shortness of breath. Pharmacist began to observe patient for signs of anaphylaxis. After not seeing any, pharmacist alerted the patient that she would be calling the ambulance for further observation. Pharmacist checked patient''s pulse which didn''t reveal any concern. EMT arrived and checked patient''s oxygen saturation which was 100%, BP and heart rate was normal. Patient was nervous about receiving the vaccine and didn''t require any further treatment at the site. Patient was able to return home with her son and stated that she was feeling better.


VAERS ID: 1518618 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

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

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

Write-up: patient passed out after 5 minutes of vaccine administration for 10 seconds. Gave her water also some orange juice, waited in the store for another 30 minutes. She was fine when leaving.


VAERS ID: 1518620 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Within 5 minutes of vaccine, developed sweating and nausea, completely resolved by 30 minutes


VAERS ID: 1518625 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

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

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

Write-up: Patient fainted after recveiving COVID 19 Vaccine. He came to immediately. We raised his legs and monitored him. His blood pressure was taken as well as his pulse. His blood pressure ranged between 108/84, 110/60 125/79. His HR wa beteen 80-90 and his O2 Sat was 95-98. Patient felt better a few minutes later. We kept him in the store and monitored him for 30 minutes. he said he was fine to leave and walked out on his own.


VAERS ID: 1518630 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Immediate post-injection reaction
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (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: Moderna (first dose)- similar reaction
Other Medications: bupropion ER/SR 150mg tab ferrous sulfate 325mg tab
Current Illness: Unknown
Preexisting Conditions: Hypermobility Anxiety Anemia
Allergies: latex hydrocodone
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt developed headache and dizziness immediately after receiving her second dose. This adverse reaction resolved on its own over the next 15-30 minutes.


VAERS ID: 1518635 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products, Wrong product administered
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer was given for 2nd dose on accident instead of Moderna


VAERS ID: 1518638 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

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

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

Write-up: Female received 2nd dose of Pfizer vaccination shot afterwards client states she feels dizzy and hot. I said busy and he is hot. Client was given water for hydration and cold ice packs were applied to face and neck. After two minutes of intervention client states she feels better and symptoms have discontinued.


VAERS ID: 1518649 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NO Allergies
Diagnostic Lab Data: 911 was contacted and EKG was done for the patient
CDC Split Type:

Write-up: Patient had 2-3 episodes of syncope and was really sweating.


VAERS ID: 1518652 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-22
Onset:2021-07-31
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Induration, Mass, Pain, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Redness pain hard lump hot to touch


VAERS ID: 1518653 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: No events occurred on site


VAERS ID: 1518654 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: Patient reports feeling dizzy, and faints. He is immediately evaluated by medical emergency personnel who proceeds to elevate lower extremities. Vital signs are monitor: BP 110/60 P 53 Sat% 99 dxt 136mg/dl. Patient regains consciousness and is placed on a stretcher. Doctor is notified by phone. Observed patient for thirty minutes to reassess BP 120/60 Sat 99 P 78


VAERS ID: 1518656 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: The patient passed-out, and jerked violently following any events involving needles.
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: PCN, Sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: The patient passed-out about one minute following the vaccine, and was jerking violently for about 2 minutes.


VAERS ID: 1518661 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: PT received Pfizer vaccination. He had stated that he had had no other vaccine series, but was found to have had Jensen prior to the clinic day.


VAERS ID: 1518669 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Latex allergy
Diagnostic Lab Data: None yet. If I get worse or my status remains the same I will seek medical attention.
CDC Split Type:

Write-up: My left arm had a burning sensation about 2 minutes after receiving the covid 19 vaccine. Approximately 57 minutes after the vaccine was administered the left side of my face became numb and heavy. I am reporting this 5 hours after the Pfizer covid 19 vaccine was given to me and my symptoms have been consistent with a moderate increase in numbness in the left side of my face. My left arm is no longer burning as that actually subsided soon after it started. My concern is the numbness and heaviness in my face.


VAERS ID: 1518671 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: PT did not tell admin that they had received a complete series prior to arrival. They claimed that it was their first dose. It was recognized later that they had a complete of Pfizer already done, and had now received a 3rd.


VAERS ID: 1518674 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: No known allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came in for second dose of the COVID vaccine and was given the Pfizer vaccine instead of the Moderna vaccine. The consent form was not filled out completely, so our intern, confirmed with patient and patient gave verbal confirmation that he was there for the pfizer vaccine. He did not have his vaccination card on him at that time. Error was not noticed until later on, after vaccination, when he gave us his card. When the error was found, we explained what happened to the patient and asked if he was feeling unusual. Patient gave confirmation that he was ok and would wait 30 minutes. After 30 minutes, intern checked with the patient that he was fine to leave. We instructed the patient to check if any unusual symptoms occur, head to emergency room right away and explain what happened. And patient confirmed.


VAERS ID: 1518676 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Hyperhidrosis, Immediate post-injection reaction, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient felt hot, profusely sweating, dizzy, and nauseous almost immediately after the vaccine. Patient was dosed with benadryl 25mg prophylactically. After about 15 minutes, patient began to feel better.


VAERS ID: 1518679 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vomiting
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient vomited about 5-10 minutes after his vaccination. No other reactions occurred.


VAERS ID: 1518681 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

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

Write-up: Syncope


VAERS ID: 1518684 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Emotional distress, Hypoacusis, Malaise, Moaning, Nausea, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient says he does NOT take any OTC meds, dietary supplements, or herbal remedies.
Current Illness: Patient said he had just recovered from a cold which included nasal congestion and cough. However, he said he had tested negative to Covid-19
Preexisting Conditions: No chronic illnesses according to patient (and his mother).
Allergies: NKA to any meds or foods
Diagnostic Lab Data: None to speak of. In speaking to Pt''s mother she says she experiences feelings of wanting to faint and nausea when she donates blood or gets injections.
CDC Split Type:

Write-up: Injected patient and about 2 minutes later he started became distressed. He was moaning and said he didn''t feel well. I went to sit next to him and he stated that he had blurred vision and couldn''t see. He also stated that his hearing was muffled. I guarded him while he sat to make sure he did not fall over and injure himself. Soon after he became nauseated and vomited two to three times. Almost immediately he felt better and recovered quickly. I offered a bottled water for him to sip on. I called his mother to advise of Pt''s condition. I kept Pt a total of about 30 minutes after the incident. I called mother and she spoke to pt. and they agreed it was okay for him to leave. EMS was not alerted nor did Pt need any First Aid or CPR. I called Pt and spoke to him at 5:00 PM this evening and he was feeling well.


VAERS ID: 1518686 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unaware
Current Illness: pt has fainted in the past during other procedures
Preexisting Conditions: not known..does not have diabetes
Allergies: nka
Diagnostic Lab Data: none
CDC Split Type:

Write-up: pt experienced lightheadedness after vaccine and fainted shortly after. She said she has fainted in the past from other procedures due to anxiety about the procedure.


VAERS ID: 1518688 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 2 LA / IM

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

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

Write-up: Client denied having had a previous dose of COVID19 Vaccine and was given a dose of J&J. Upon documenting in ALERT, the agency discovered the client did receive a previous dose on 4/2/2021. Previous dose confirmed with vaccinator. There was no indication of adverse reaction. This is an error report only.


VAERS ID: 1518690 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Confusional state, Dizziness, Hyperhidrosis, Hypotonia, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Attendee received first dose Pfizer vaccine at 12:26 pm in the left arm. Lot# EW0170. Attendee was directed to observation area. At 12:36 sitting in the observation area in a tripod position and lost consciousness and stumped against the admin, who had come over to check on him. Loss of consciousness x 15 seconds. Attendee assisted to the cot to lie down, as was now completely awake and sitting in semi ? fowler position on the cot. A little bit confused, diaphoretic and pale. Voiced complaints of dizziness. Icepack applied to the neck. 12:38 ? No longer confused. Refusing 911 to be called. HR: 54 BP: 110/60 RR: 20 O2Sat%: 100


VAERS ID: 1518694 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blindness, Cyanosis, Deafness, Depressed level of consciousness, Dizziness, General physical health deterioration, Heart rate decreased, Incoherent, Pallor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 5 minutes after giving the vaccine I was called because someone had either passed out or was about to pass out. When I got there the patient was very pale and feeling dizzy. She was still fully conscious so I got her a bottle of water to sip and went to get the pulsoximeter. Her initial reading was O2 of 95% and heart rate 68. She progressively got worse, saying her stomach hurt and she felt like she was going to throw up, she kept closing her eyes, and not talking coherently. The pulsoximeter started to beep showing her heart rate was in the 40''s. I quickly went to get the epipen and another pulsoximeter to double check the reading. That monitor was also reading in the 40''s and then to 39 for heart rate. By this time the patient lips and cheeks had turned blue and she was barely conscious. I told my technician to call 911 and I administered an epipen. After just a minute or two her stats came back up to heart rate 56 and then to the 69-72 rate with 100% oxygen. She was fully conscious and talking but complaining of dizziness. When she was talking she told me how she remembered during the episode that she couldn''t hear anymore and everything had gotten black. I stayed with her until EMS came to take her and they said good job. The girl was ok when I handed her off.


VAERS ID: 1518696 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Haematemesis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (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: Aimovig Autoinjector FLUoxetine rosuvastatin SUMAtriptan
Current Illness: no
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: throwing up blood


VAERS ID: 1518697 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: During the observation period, the patient''s mother came up to the pharmacy to inform that her daughter''s vision was "becoming blurry". Pharmacist assessed patient who was alert but was feeling warm, lightheaded, and was having difficulty seeing. Pharmacist obtained cold water bottles for the patient. Patient fainted but was responsive when calling her name. When patient became alert again, BP 88/49 and HR 67 was obtained. EMS was not required. Advised patient to remain seated for at least another 15 minutes. She was provided white soda and a snack. Patient and mother were educated again on the vaccine''s potential side effects and how to respond/call for help.


VAERS ID: 1518698 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Headache, Neck pain
SMQs:, Arthritis (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: Zetia Repatha OCP
Current Illness:
Preexisting Conditions: High Cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache Neck pain Ears and face feel hot


VAERS ID: 1518701 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Fear of injection, Headache, Hyperhidrosis, Loss of consciousness, Mastication disorder, Nausea, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no. not mentioned
Current Illness: no
Preexisting Conditions: Seizures but not in over 5 years
Allergies: no. not mentioned
Diagnostic Lab Data: I took blood pressure 107/77 pulse 78
CDC Split Type:

Write-up: after sitting him to wait 15 min he passed out and fell out of his chair. Pale, sweaty and nauseated but did not throw up. Said it was his needle phobia. Called later after the episode was over and he drove home to tell me his head hurt when he chewed so he would assume his head hit the floor.


VAERS ID: 1518704 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Adverse reaction, Cold sweat, Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Attendee voice complaints of dizziness and nausea 5 minutes after the vaccine administration. Vomited x 1. Skin cool and clammy. 10 minutes later the attendee was feeling much better and was asymptomatic. Blood pressure was 98/70 when the adverse reaction occurred.


VAERS ID: 1518705 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No known
Current Illness: No known health condition. After patient fell down, he/his family reported patient had before after blood draw.
Preexisting Conditions: No known
Allergies: No known allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received his 1st dose of Pfizer covid vaccine. And about 5 minutes later, he fell down and hit his head on the floor. He was alert and conscious the whole time. 911/paramedic was called and patient was taking to hospital for precaution.


VAERS ID: 1518707 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature fluctuation, Diarrhoea, Dizziness, Ear pain, Incontinence, Injection site pain, Migraine, Pain, Pain in jaw, Urinary retention
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Osteonecrosis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Testosterone cypionate, multi vitamin
Current Illness: Covid-19 4 weeks prior
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme migraine, ibuprofen. Temperature fluctuate between 104-96. Body aches. Joint pain. Extreme injection site pain. Dizziness. Incontinence, diarrhea, jaw pain, ear pain, inability to urinate.


VAERS ID: 1518712 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-01
Onset:2021-07-31
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04021A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Ear, nose and throat examination, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None. 15 minutes after vaccination there was throat swelling on the left side. Shortness of breath and light headedness followed.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Vital sign monitoring and examination of the throat.
CDC Split Type:

Write-up: Throat swelling, shortness of breath, light headedness. Occured approximately 15 minutes after shot. Contacted pharmacist, who referred to Emergency Room. Emergency Room Doctor prescribed antihistamine and steroid via IV line. Prescribed Benadryl and Prednisone for 3 days.


VAERS ID: 1518714 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Influenza like illness, Pain, Pyrexia
SMQs:, 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: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe flu-like symptoms: Body aches, fever, uncontrollable shivering, fatigue and weakness. Onset: `3.5 hours post injection with sudden onset continuing into the night. Symptoms have improved briefly but still continue 9.5 hrs post-vaccination. Treatment: 600mg Ibuprofen IO q/6hr


VAERS ID: 1518730 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Feeling abnormal
SMQs:, Dementia (broad), Accidents and injuries (narrow)

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

Write-up: I was administering the Pfizer vaccine to patient around 10:23am. After given the vaccine, I asked patient to sit on the chair in front of pharmacy for 15 minutes post vaccination observation. After few minute later I heard the loud sound "bang" like something hitting the floor. Then I ran out to the front of the pharmacy, patient was lying on the floor facing down. I kneel down, turn patient over and assess to see if patient is conscious and breathing. Patient was alert oriented. He was able to tell me he didn''t know why he spaced out for a second and fell down during that second. He said he fell so much better laying down on his back. He said his breathing is normal. He also tell me he didn''t sleep well last night and he didn''t know if maybe he feel sleepy. When paramedic came, his blood pressure is 127/70, blood sugar is 157, oxygen 94. They assessed him and said he doesn''t have any sign of trauma from the fall. However, patient decided to go with them to the hospital to check to see if there is any concussion from the fall. At 4pm, I called patient, he sound fine over the phone. He said he only spent about 30 minutes in the hospital. He said they assess him and said he was having psychological issue which too much anxiety that was why he fainted (During screening, he didn''t show or tell me he was severe nervous). He said he was trying the hide his nervousness in front of me. I ask patient in the future please tell any healthcare provider about this so we can be more caution and better monitoring post vaccination.


VAERS ID: 1518737 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-17
Onset:2021-07-31
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Rash, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: My arm became sore more than when I first got the vaccine and I developed a large red rash on my arm. It was also very hot to touch. It did not itch.


VAERS ID: 1518738 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus shot when I was 16 years old.
Other Medications: Leviothyroxin and BCP
Current Illness: None
Preexisting Conditions: None
Allergies: Tetanus shots and blueberries
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on stomach and back. I am not totally sure when it started but I noticed it today. The first 10 hours after the shot I had difficulty breathing when standing or walking, chills, fever and body aches.


VAERS ID: 1518767 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 LA / IM

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

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

Write-up: Systemic: Exhaustion/Lethargy-Mild, Systemic: Fainting/Unresponsive-Mild, Systemic: Weakness-Mild.


VAERS ID: 1518768 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 RA / IM

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

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

Write-up: Systemic: Confusion-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Mild, Additional Details: right after i gave the patient the vaccine, the patient fainted and blacked out. The patient then proceeded to seize


VAERS ID: 1518769 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Fall, Flushing, Heart rate increased, Hyperhidrosis, Hypotension, Loss of consciousness, Skin laceration, Syncope, Tachycardia, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Systemic: Tachycardia-Mild, Additional Details: within minutes of receiving vaccine pt passed out falling face first onto floor. pharmacst rushed to pt who was conscious but disoriented. pt was rolled onto back and assessed and found to have 2 abrasions on face due to fall. pt stated she was ok. 911 was called. pharmacist checked pt bp and found it to be 122/48. pt was given water and monitored until ems arrived. EMS arrived and transported pt to ER due to heart rate still being high (130).


VAERS ID: 1518777 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Hypotension, Nausea, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Nausea-Medium


VAERS ID: 1518782 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Paraesthesia, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Severe, Systemic: Shakiness-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: tingling in hands


VAERS ID: 1518783 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Systemic: Weakness-Mild, Additional Details: A 12 y/o female got 2nd dose pfizer vaccine, verbally informed to sit for 15 mins which she complied to. Few minutes after the administration while seated, patient fainted, fell on the ground as stated by her mother. Another caregiver called me stating someone had fainted. I rushed to the seating area, found patient on the ground slightly conscious with her eyes open but weak. I offered water , to call 911 but declined. She was monitored for 15 more mins and left the pharmacy. I will follow up


VAERS ID: 1518784 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Arthritis (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: na
CDC Split Type:

Write-up: lightheaded joint pain problem with balance


VAERS ID: 1518785 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 7485 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills
SMQs:, Arthritis (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: pain killers
Current Illness: problems with low back
Preexisting Conditions: low back
Allergies: no
Diagnostic Lab Data: no
CDC Split Type:

Write-up: Joint pain chills left arm


VAERS ID: 1518798 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Induration, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 2 inch red circle. Warm to the touch, hard to the touch as well.


VAERS ID: 1518799 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Heart rate increased, Loss of consciousness, Pyrexia, Syncope, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Supine Vitals post passing out: 110/55, HR 68, o2 93%. I was taking vitals seated when he passed out the second time around 9:30pm and got HR of 55 but then he collapsed prior to getting BP. In the first 5 hrs after he passed out his HR varied from 88-127 , o2 varied from 84-97%, he had fever of 101 and chills, no body aches, headache present, BP stabilized to 118/64 supine. We didn''t take him to the ER and monitored him every hour for the first 5 hours post event. HR still elevated the next morning, staying around 100 bpm.
CDC Split Type:

Write-up: He passed out twice, vision changes prior to passing out. HR remained elevated for 12 hours after passing out, between 88-127 as we monitored it. Shivering and headache after passing out. Laying down didn''t bring him out of the passed out state. He didn''t come to until his feet were elevated a few seconds. BP afterward when laying down was 110/55, HR 68. He had COVID back in Dec 2020 with very mild symptoms. Totally healthy and feeling good when he got the vaccine yesterday and he is a very healthy 19/yo male.


VAERS ID: 1518805 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Eye movement disorder, Hyperhidrosis, Loss of consciousness, Nausea, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Morphine er 15 mg 1q12 hours Hydrocodone-apap 10/325 mg 1q12 hours
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Melatonin
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Approximately 5 minutes after injection patient briefly lost consciousness. He became pale and started sweating. He appeared confused and his eyes had rolled back in his head. We attempted to move him to the floor as he appeared to be fainting but he then came out of it. He was confused and thought he had fallen asleep. He remained nauseous, pale and sweaty. 911 was called at the time of occurrence and EMTs came to assess the patient and took him to the hospital.


VAERS ID: 1518815 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Dizziness, Headache, Injected limb mobility decreased, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Soreness of arm injected, can barely move it. Fever. Body aches all over. Dizziness. Headache.


VAERS ID: 1518818 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Heart rate increased, Painful respiration
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: We plan on contact his doctor in the morning on Monday
CDC Split Type:

Write-up: at approximately 11 PM on 7/31, my son started complaining about chest pain. As he was laying in bed he felt chest pain while he was breathing. He described it as a significant pressure causing pain (asked about pain level 1-10, he said 8, he was in pain) being stubborn he wanted to sleep it off, he ended up getting some sleep last night but this morning he is still feeling the pain while inhaling, current level of pain he describes as 4. I checked his blood pressure it was normal but I noticed increased heart rate at 94 per minute at 10 AM on 8/1.


VAERS ID: 1518820 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Eye pain, Musculoskeletal stiffness, Somnolence, Trismus
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Arthritis (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: Vitamin C and Vitamin D supplements
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Back pain, joint pain, stiff fingers and toes, jaw twitch, eye soreness, sleepiness


VAERS ID: 1518833 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-27
Onset:2021-07-31
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clindamycin hcl , levothyroxine Nebivolol
Current Illness: No
Preexisting Conditions: Thrilled, high blood pressure
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: After first day got shill over body, and on six day got hives all over my body and face


VAERS ID: 1518849 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / SYR

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

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

Write-up: Fever (101.8?F), Fever (100.2?F), chills, lightheaded, headache


VAERS ID: 1518868 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram, Urine analysis, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Drospirenone-Ethinyl Estradiol 3-0.02 MG Tablet Take 1 Tablet by mouth daily.
Current Illness: Viral cold Nasal congestion, sore throat, slight cough from drainage. Tested negative for Covid.
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: EKG, blood work, urine test, xray, ct scan.
CDC Split Type:

Write-up: Chest pain/pressure, shortness of breath and sharp stabbing pains in chest.


VAERS ID: 1518882 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 10-15 minutes after receiving vaccine patient reported the following symptoms: dizzy, nausea, sweating, blurry vision


VAERS ID: 1518890 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Feeling cold, Hyperhidrosis, Syncope, Vision blurred, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: The patient received the shot today around 6:00pm and I had him sit down after the shot. I explained to him that he had to wait 15 minutes just to make sure he was okay. As I was putting the sharp container back. He fainted and fell on the floor. I immediately ran out and sat him back down because he had gotten up off the floor. I saw he was still sweating, I told him don''t move and laid his head back on the bench. I got the ice pack and a bottle of water for him. He said his eyes was blurry as I continued to hold the ice pack and give him water. He then told me he felt like he wanted to vomit, I ran back in the pharmacy looking for a garbage can but didn''t see one, so I grabbed a bunch of paper towels and as I got back to him he was vomiting. I put the ice pack back to his head for about 5 more minutes and he then said he was feeling much better and he could hold the water bottle and drink some by himself. I asked him when was the last time he had eaten and he said for breakfast and it was 6pm now. I told him that he should have at least eaten lunch before getting the shot and he is a college student and he said he was saving the little money he had for food. I wanted to send him home with some Tylenol just in case he developed a fever or got chills later because he said he was cold. I bought him some Tylenol and had him sit for 30 more minutes and when he left I had my technician walk him to the door to make sure he was still okay to drive.


VAERS ID: 1518906 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Dizziness, Flushing, Hyperhidrosis, Nausea, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Mild, Systemic: Weakness-Mild


VAERS ID: 1518907 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

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

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

Write-up: Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Additional Details: Red swollen area at injection site with spreading redness/rash


VAERS ID: 1518915 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin. Motrin.
Current Illness: Cold 1 week prior
Preexisting Conditions: None
Allergies: Neosporin, bacitracin, doxycycline, Minoncin, tetracycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large hive to area below injection site. Hive turned into cellulitis.


VAERS ID: 1518920 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Seizure, Skin warm, Tremor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient started seizing after she received vaccine. Patient was unresponsive and shaking. Her skin was warm and clammy. After a few minutes, she was responsive and was able to answer questions when EMT arrived.


VAERS ID: 1518922 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-22
Onset:2021-07-31
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site reaction, Injection site warmth, Limb mass, Pain in extremity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 5 inch welt at injection site, itching, feverish to touch, lump in arm, pain in arm


VAERS ID: 1518928 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Patient reported recovering from acute cold recently
Preexisting Conditions: AsthmA
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient expressed anxiety and hesitations about receiving the moderna vaccine. Prior to administration she discussed benefits and possible side effects with pharmacist and was asked 3 separate times whether she wanted to receive it and she stated yes. After administration she went to the restroom and came back at 5:36pm. Approximately 11 minutes after administration patient stated she felt like her throat was closing up and asked the pharmacist to call 911. 911 was immediately called (approximately 5:36pm). Patient reported she did not feel dizzy or like she was going to faint and did not have any noticeable swelling or rash appearing. She was alert, sitting or standing, and able to speak during the entire visit in the pharmacy. She had minimal coughing and did not appear to be in respiratory distress. Store manager arrived in pharmacy at 5:43pm and asked patient if she was ok. Patient stated she was coughing and proceeded to explain that she had asthma. Pharmacist stayed on the phone with 911 dispatcher until ems arrived. Ems arrived at 5:46pm and transported patient to the hospital for further evaluation and treatment


VAERS ID: 1518939 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-28
Onset:2021-07-31
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: patient had nausea and enlarged lymph nodes with severe pain radiating down arm. referred to physician for follow up


VAERS ID: 1518945 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-27
Onset:2021-07-31
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Magnetic resonance imaging, Pulmonary embolism, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow)

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

Write-up: Bilateral PE


VAERS ID: 1518951 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Jaw chattering chills started roughly 12hrs after injection. Fever associated with chills. Both chills and fever subsided by 24hrs post injection. Severe Muscle aches and joint point set in on day 2.


VAERS ID: 1518953 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020BZIA / UNK LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Erythema, Fatigue, Illness, Lethargy, Nausea, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium supplement at night for sleep. Probiotics every morning. Flonase in AM.
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in arm a few hours after vaccine. Lethargy the next day and more intense pain in arm. That evening had upset stomach and diarrhea and nausea. The next morning left arm was red and warm and still intense pain. Feeling of fatigue and overall sickness.


VAERS ID: 1518956 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Cardiac arrest, Hyperhidrosis, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Mom said that her son has had anxiety attack in the past
Other Medications: na
Current Illness: no
Preexisting Conditions: no known history
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient sweated, skin color was changed to very pale white color, and passed out, but regained consciousness. We checked his vitals (118/79, 57) and called 911. Paramedics came and checked on him, but pt passed out again after he was asked to stand up. His blood pressure dropped very low and heart stopped for about 10 seconds. Therefore, he was taken to hospital.


VAERS ID: 1518957 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Headache, Insomnia, Lethargy, Malaise, Mobility decreased, Muscle spasms, Pain
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Multivitamin and daily iron supplement
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chills followed by excruciating pain making me unable to move or even hold my phone to call for help. The chills caused muscle spasms that seized most of my body and I could not sleep or move for approximately 10 hours. Afterward pain subsided enough for me to get up and take some ibuprofen so I could sleep. Now I just feel lethargic with a mild headache and some lower back pain but the chills and spasms are gone. I thought I was going to die last night and would have gone to the ER had I been able to call for help.


VAERS ID: 1518959 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had mild tongue swelling after 5 minutes of vaccination, she took 25 mg of benadryl as a pre-medication and also repeated this when the symptoms started. She has a history of anaphylaxis to vaccinations.


VAERS ID: 1518973 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pt had had this adverse effect with other vaccines
Other Medications: na
Current Illness: no
Preexisting Conditions: no
Allergies: fruits
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s color skin change to very pale color and passed out, but regained consciousness. She had a little light headache and felt ok after a few minutes of resting. She did not want us to call 911.


VAERS ID: 1518974 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Crying, Mobility decreased, Pain, Weight bearing difficulty
SMQs:, Parkinson-like events (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse; Baclofen; Multivitamin
Current Illness: None
Preexisting Conditions: DDD in back, depression, ADD
Allergies: Latex, penicillin
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: I woke up the dat after I received my covid vaccine, and my left wrist had some pretty significant pain. It wasn''t swollen, but I couldn''t put any weight on it. I took some naproxen, put Voltaren gel on it, and took some turmeric hoping it would get better. It didn''t. The next day, today, it is worse. I can''t move it without it being very painful. I''ve been to the point of tears all day because of how bad it''s hurting. I am contemplating going to an urgent care or ER.


VAERS ID: 1518999 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-31
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Condition aggravated, Dyspnoea, Musculoskeletal chest pain, Pain in extremity, Somnolence, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), 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: Diltizem CD 120mg twice daily, levothyroxine 0.88mcg, baby aspirin chewable 81mg, vitamin c 1000mg, D3 2000 iu, womens one a day multi vit, iron supplement, elderberry, zinc 50mg.
Current Illness: History of Asthma, tachycardia issues, hypothyroidism, hx of anemia, elevated d dimer,fibroids, over weight
Preexisting Conditions: Asthma, hypothyroidism
Allergies: Macrobid, keflex, mushrooms,
Diagnostic Lab Data: Had blood work done before vaccine on July 14th 2021, had low vitamin D and slight elevated d dimer. Primary care doctors stated to take baby aspirin 81mg daily repeat d dimer in a month.
CDC Split Type:

Write-up: First day Sore arm, chest felt heavy for a split second. Next day Woke up at 3am with tachycardia lasted for 2 to 3 mins. Sunday knee soreness, left lower rib cage sore. Mild short of breath and sleepy.


VAERS ID: 1519009 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Dysphagia, Hypoaesthesia oral, Pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Trigeminal Neuralgia and Fibromyalgia
Preexisting Conditions: Trigeminal Neuralgia and Fibromyalgia
Allergies: penicillin
Diagnostic Lab Data: not available
CDC Split Type:

Write-up: Patient received 2nd dose at approximately 4:07 pm administered by immunizing technician supervised by pharmacist. At approximately 4:20 patient stated that she felt tightness when breathing. At this time of complaint, the patient said that she felt tightness in her chest when breathing but has asthma. The patient said that her breathing was getting better. Pharmacist administer 10ml of liquid oral benadryl at 4:30 and at 4:36 to equal a total of 50mg. Monitoring of the patient continues, with patient stating that breathing is better. At 4:47pm patient complains that the tip of her tongue feels numb. patient did state that she had no trouble breathing. At 4:55pm, patient complains that she thinks she might have trouble swallowing , at this point pharmacy called 911. Emergency Medical Technicians came and patient stated to the EMT that she does have anxiety and refused to go the hospital because she stated that she was feeling better. At 7:36 pm called and followed up with patient and patient states that her she has no problem breathing but her tongue feels a little numb On 8/1/21, called patient and patient states that she is having aches and body pains and that her tongue was feeling numb still. Pharmacist urged patient to see physician.


VAERS ID: 1519013 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-07-22
Onset:2021-07-31
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Big red rash when shot was administered (around 3in x 5in), itchy


VAERS ID: 1519022 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: didn''t state which vaccine but has a fear
Other Medications: unknown
Current Illness: no
Preexisting Conditions: no
Allergies: norco
Diagnostic Lab Data:
CDC Split Type:

Write-up: Idiopathic vasovagal reaction, lasted about 30 seconds. emergency response activated. Evaluated by EMS after and released with mother.


VAERS ID: 1519044 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D31A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia oral, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lyrica Pantoprazole Linzess Gabapentin Topiramate Motegrity Baclofen Enoxeparin Clonidine Cyproheptadine Benadryl Ondansetron
Current Illness: Not known
Preexisting Conditions: Neuropathic pain , GI issues (details unknown)
Allergies: Iodine Reglan Shellfish
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient had tingling in the mount and felt like her tongue was swelling about two hours after vaccination. Paramedics were called who took her to the ER


VAERS ID: 1519047 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (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:
Current Illness:
Preexisting Conditions:
Allergies: Had adverse reaction to supplement PS 150.
Diagnostic Lab Data:
CDC Split Type:

Write-up: After I received the shot, I walked out to the store to browse. Within 1-2 minutes I began to feel lightheaded and my heart began to pound rapidly. I went back to vaccination area and sat down with pharmacist. My heart continued to pound rapidly for about another 4-5 minutes. Once my heart slowed down, I continued sitting about another 5min, as I still felt lightheaded. I then left the store to walk outside in fresh air. I had to sit down outside because I felt weak (about 15 min post shot) As I was resting, my heart began to beat rapidly again for about 30sec-1min. It took about 45m for my lightheadedness to fully subside.


VAERS ID: 1519062 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

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

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

Write-up: patient fainted after the vaccination while sitting in the chair just outside the pharmacy. patient soon became responsive and was assessed. No allergic reaction was present, and it was deemed vasovagal syncope.


VAERS ID: 1519069 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 20 mg/daily
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body tingling, light headedness, nausea, vomiting


VAERS ID: 1519098 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: 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: Pre-natal vitamins
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever of 103.3 for 24 hours. Tylenol barely brought in down.


VAERS ID: 1519103 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cardiac flutter, Discomfort, Hypotension, Mast cell activation syndrome, Migraine, Pain, Palpitations, Somnolence
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tirosint 88 daily for Thyroid (last two days prior); intermittent/varying Claritin OTC + Pepsid OTC / Cromolyn for Mast Cell Disease. Occasional Tylenol. Multivitamin, sometimes Vitamin C, B, D, Omega3.
Current Illness: Mast Cell Disease ( unclear whether Systemic Mastocytosis or high grade MCAS at this time) ... based upon elevated Baseline Serum Tryptase + N-Methylhistamine + CD25 on GI Biopsies, High MC Count in GIT, etc. Hyperadrenergic POTS... based upon Dysautonomia + Recurrent Pre/Syncope with paradoxical BP, Increase in BP Upright (storms with movement), High Metanephrines + Catacholamines (Norepinephrine, Dopamine), increase in Norepinephrine to $g600 Upright. Modular Thyroid Disease $g Thyroidectomy + Parathyroid Autotransplant $g Hypothyroid, reasonably controlled
Preexisting Conditions: Mast Cell Disease (post-Thyroid Disease & Surgery) Dysautonomia, Hyperadrenergic POTS (post-Thyroid Disease &. Surgery) Persistently elevated Epstein-Barr Titers (IgM, EA-D) Modular Thyroid Disease with transient TPO Ab (apparently following acute EBV)
Allergies: Bactria (Severe Systemic), Synthroid (Anaphylactic), SIBO Meds (Systemic), CT Contrast (flu-like + diffuse Rash), Nickel, Gold Compound, Mold, various Foods (e.g., eggs, spinach, pineapple, chocolate, tomatoes, oatmeal... all these only in more than small doses).
Diagnostic Lab Data:
CDC Split Type:

Write-up: Triggered typical Mast Cell Reaction (e.g., severe Facial Migraine + Migraine exactly like those encountered in Histamine onslaughts triggered by certain foods/Allergens). The Reaction may have been Delayed due to double Premedication (H1+ H2) before shot. This was not a regular Headache (Tylenol did nothing), rather a typical Mast Cell Degranulation event (additional H1) abated within about 12-15 hours. There were also Cardiovascular Symptoms typical to Mast Cell events (e.g., Hypotension, Palpitations/Flutter, inability to stay awake, etc.), but I cannot be sure that these were not caused/contributed to by the Antihistamines. Notably, there is Liable Hypotension-Relative Hypertension at the Baseline, so difficult to parse this component. But, the nature, severity and degree of the Histamine Symptoms would seem clearly attributable to the Drug. I would recommend that anyone who has Mast Cell Disease should Pre-Medicate with H1 + H2 +/- Monteleukast, but continue this on for at least 1-2 days after the Second MRNA Pfizer COVID Vaccine. The effect was severe Pain and discomfort, but would do the Shot again due to short duration. HOWEVER, I would have some concerns if a third Booster Dose becomes necessary. In my experience, that?s how Anaphylaxis/Severe Systemic Drug Reaction goes... worse with each following Dose.


VAERS ID: 1519106 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-23
Onset:2021-07-31
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Dyspnoea, Pulmonary pain
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Woke up with extreme pain in my chest and back and shortness of breath. I felt like my lungs were being crushed when I bent over. The pain is localized to the left side of my chest. Today is day two, and the pain has lessened and isn?t constant, but I still have shortness of breath. I am choosing to heal through rest and self-care.


VAERS ID: 1519114 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
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: PT FILLED OUT THE CONSENT FORM FALSELY INDICATING SHE NEVER RECEIVED COVID VACCINE PREVIOUSLY AND I WENT AHEAD AND GAVE HER PFIZER COVID SHOT PER HER REQUEST. LATER WHILE PROCESSING THE FORM I GOT FLAGGED SHOWING THAT SHE HAD ALREADY GOTTED JANSSEN COVID 19 VACCINE ON 3-6-21. THEN I CALLED HER TO CONFIRM THAT AND SHE CONFIRMED THAT YES SHE GOT JANSSEN COVID 19 VACCINE PREVIOUSLY BUT SHE FALSELY INDICATED SHE NEVER GOT ANY SO SHE CAN GET THE PFIZER SHOT.


VAERS ID: 1519136 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Topical anesthetic
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red, itchy and painful rash in both sides of neck and injection site arm area


VAERS ID: 1519138 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-07-31
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Aspiration pleural cavity, Atrial fibrillation, Cardiac failure, Echocardiogram, Ejection fraction decreased, Pleural effusion, White blood cell count normal
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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

Write-up: Acute respiratory failure, pleural effusion (1.5L removed), heart failure, new onset atrial fibrillation, normal WBC (no sepsis), echo 2 weeks prior to event showed normal LV function with EF of 60%


VAERS ID: 1519140 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-07-31
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Aneurysm repair, Cerebral endovascular aneurysm repair, Subarachnoid haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Non traumatic subarachnoid hemorrhage requiring IR coiling and embolization, no HTN history


VAERS ID: 1519142 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, 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? 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: Onset of localized pain at injection site, approximately 48 hours after the injection accompanied by a raise red bump at the injection site.


VAERS ID: 1519144 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Hyperhidrosis, Hypotonia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: AFTER THE PATIENT HAD BEEN SITTING IN THE WAITING AREA ABOUT 8-10 MINUTES I LOOKED UP FROM DRAWING MORE VACCINES TO DISCOVER THE PATIENT''S HUSBAND HOLDING THE PATIENT WHO WAS SLUMPED IN HER CHAIR. WHEN HE SAW ME LOOKING HE WAVED HIS HAND AND SAID SHE''S OK , SHE''S FINE. I DROPPED WHAT I WAS DOING AND WENT OUT TO CHECK ON HER. HE STATED SHE DOES THIS ANYTIME SHE GETS A SHOT AND SAID SHE''D BE OK IN A MINUTE. I ASKED IF HE WANTED ME TO CALL AN AMBULANCE TO CHECK HER OUT. HE SAID NO, YOU JUST HAVE TO GIVE HER A MINUTE. HE STATED HE''D BEEN THROUGH THIS WITH HER MANY TIMES BEFORE. I GOT HIM A DAMP PAPER TOWEL AND AND CARD TO FAN HER WITH, SINCE SHE WAS SWEATY. THE PATIENT PERKED UP IN A FEW MINUTES. SHE SAID SHE FELT OK AND I THEN HAD MY TECHNICIAN TAKE HER SOME WATER. I FOLLOWED UP WITH THE PATIENT THE FOLLOWING DAY AND SHE STATED SHE WAS DOING FINE BUT THAT THE VACCINE HAD KIND OF "ZAPPED" HER. SHE STATED SHE HAD A COUPLE OF THE EXPECTED SIDE EFFECTS HEADACHE AND FATIGUE.


VAERS ID: 1519149 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 7485 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

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

Write-up: Shortness of breath and tightness in chest. Feels like a heart palpitations. Anxiety.


VAERS ID: 1519157 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin calcium 5mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, dizziness, vomiting


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