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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 319 out of 7,116

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VAERS ID: 1535986 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-23
Onset:2021-07-31
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Maxzide, metformin, aspirin, zinc, Zyrtec, vitamin D3, vitamin C
Current Illness: n/a
Preexisting Conditions: Type II diabetes, hypertension, hemochromatosis
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8 days after vaccination: sore throat, runny nose, sneezing, nasal congestion, dry cough, tiredness


VAERS ID: 1536089 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023D21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dyspnoea, Injection site discolouration, Injection site nodule, Nausea, Night sweats, Syncope, Throat tightness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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:
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Knot on arm is turning black at injection site, night sweats, nauseous, throat closed- could not breathe, weak, chills, vomiting, fainted.


VAERS ID: 1536134 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0169 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT APPLICABLE
Current Illness: NONE
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: VACCINE RECIPIENT RCD 2 PFIZER C- 19 VACCINE DOSES PRIOR TO THIS, ON 12-18-2020 AND 1-7-2021, WITHOUT ADVERSE EFFECTS. ON 7-31-2021 AT A SPONSORED HEALTH PROMOTION AT, RECIPIENT WAS TESTED FOR COVID IGM AND IGG ANTIBODIES BY AN OU RESEARCH IMMUNOLOGIST AS PART OF A GRANT-SPONSORED STUDY. HER IGG ANTIBODIES WERE REPORTED AS VERY LOW. AS THE CLINIC WAS CLOSING, THERE WERE PFIZER C-19 VACCINE DOSES TO BE WASTED. THE RECIPIENT REQUESTED A 3RD DOSE (BOOSTER) AND THE DRH VACCINE COORDINATOR (VC)APPROVED IT BASED ON RECIPIENT''S LOW IGG RESULTS, RECENT REPORTED STUDIES AND VACCINE THAT WOULD BE WASTED. THE VC DID NOT HAVE AUTHORITY TO APPROVE THIS BOOSTER DOSE.


VAERS ID: 1536135 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0169 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood immunoglobulin G, Blood immunoglobulin M, Extra dose administered, SARS-CoV-2 antibody test positive
SMQs:, Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT APPLICABLE
Current Illness: NONE
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: VACCINE RECIPIENT RCD 2 PFIZER C- 19 VACCINE DOSES PRIOR TO THIS, ON 12-18-2020 AND 1-7-2021, WITHOUT ADVERSE EFFECTS. ON 7-31-2021 AT A SPONSORED HEALTH PROMOTION AT, RECIPIENT WAS TESTED FOR COVID IGM AND IGG ANTIBODIES BY AN OU RESEARCH IMMUNOLOGIST AS PART OF A GRANT-SPONSORED STUDY. HER IGG ANTIBODIES WERE REPORTED AS VERY LOW. AS THE CLINIC WAS CLOSING, THERE WERE PFIZER C-19 VACCINE DOSES TO BE WASTED. THE RECIPIENT REQUESTED A 3RD DOSE (BOOSTER) AND THE VACCINE COORDINATOR (VC)APPROVED IT BASED ON RECIPIENT''S LOW IGG RESULTS, RECENT REPORTED STUDIES AND VACCINE THAT WOULD BE WASTED. THE VC DID NOT HAVE AUTHORITY TO APPROVE THIS BOOSTER DOSE.


VAERS ID: 1536136 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0169 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT APPLICABLE
Current Illness: NONE
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: VACCINE RECIPIENT RCD 2 PFIZER C- 19 VACCINE DOSES PRIOR TO THIS, ON 12-17-2020 AND 1-7-2021, WITHOUT ADVERSE EFFECTS. ON 7-31-2021 AT A SPONSORED HEALTH PROMOTION AT, RECIPIENT WAS TESTED FOR COVID IGM AND IGG ANTIBODIES BY AN OU RESEARCH IMMUNOLOGIST AS PART OF A GRANT-SPONSORED STUDY. HER IGG ANTIBODIES WERE REPORTED AS VERY LOW. AS THE CLINIC WAS CLOSING, THERE WERE PFIZER C-19 VACCINE DOSES TO BE WASTED. THE RECIPIENT REQUESTED A 3RD DOSE (BOOSTER) AND THE DRH VACCINE COORDINATOR (VC)APPROVED IT BASED ON RECIPIENT''S LOW IGG RESULTS, RECENT REPORTED STUDIES AND VACCINE THAT WOULD BE WASTED. THE DID NOT HAVE AUTHORITY TO APPROVE THIS BOOSTER DOSE.


VAERS ID: 1536313 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaemia, Arthralgia, Blood chloride decreased, Blood potassium decreased, Erythema, Joint swelling, Pain in extremity, Peripheral swelling, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, metoprolol, Zestoretic, buspirone
Current Illness:
Preexisting Conditions: HTN
Allergies: None
Diagnostic Lab Data: Mild anemia, mildly low potassium and chloride.
CDC Split Type:

Write-up: 10 hours after vaccine, developed foot and ankle swelling, redness, warmth and pain. Fever up to 101 the next day. Foot and ankle swelling and pain persists for 9 days and counting.


VAERS ID: 1536341 (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: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

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

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

Write-up: Patient received dose #1 of Pfizer vaccine on 6/10/2021 @ Vaccination site and was notified by email that vial was left in freezer past recommended time frame. Medication expired beyond its freezer allowable date. Email recommended patient get re-vaccinated with dose again. Affiliated Physicians re-administered dose on 7/31/2021 as recommended. No adverse reactions identified on site.


VAERS ID: 1536445 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-10
Onset:2021-07-31
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 15M20A / UNK - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Covid Antigen Test - Positive 8/6/2021
CDC Split Type:

Write-up: Tested Positive for Covid 8/6/21


VAERS ID: 1536550 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-04
Onset:2021-07-31
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Atrial fibrillation, COVID-19, Chills, Cough, Fatigue, Hypoxia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: COVID: Symptom onset 7/31. Diagnosed 8/2. Has been having progressive Fever, chills, dry cough, and fatigue/weakness. Fully vaccinated for COVID. Denies any SOB or CP. No abdominal pain or nausea. Found to be hypoxic in the ED requiring 2-4L. Also found to be in AFib with RVR unto the 150s. 8/9: Currently on 15 L/m Non-rebreather


VAERS ID: 1536853 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-21
Onset:2021-07-31
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Plaquenel, Gabapenton,Semvastaton,Metaproparol
Current Illness:
Preexisting Conditions: Lupus
Allergies: Codeine
Diagnostic Lab Data: Ultrasound
CDC Split Type:

Write-up: Blood clot left inner arm


VAERS ID: 1540321 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-29
Onset:2021-07-31
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension
Allergies: Unknown
Diagnostic Lab Data: Covid 19 PCR = Positive
CDC Split Type:

Write-up: As of case investigation on 8/5/21 case symptoms included runny nose and cough.


VAERS ID: 1540519 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anal incontinence, Bladder dysfunction, Gait inability, Musculoskeletal disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious diarrhoea (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: Vit D Zinc MVI Eliquis 5mg BID Provastatin 40mg QD Gabapentin 100mg BID Losartan 150mg QD
Current Illness: None
Preexisting Conditions: Sciatica, Hypercholesterolemia, Hypertension, History of blood clot
Allergies: No Known Allergens
Diagnostic Lab Data:
CDC Split Type:

Write-up: Loss of the ability to walk, could not control bowel or bladder function. Upper extremities worked and lower extremities did not work for 2 hours the day following vaccination. Took Tylenol for fever also following day.


VAERS ID: 1540610 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-06
Onset:2021-07-31
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Menopause, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxin 100mcg
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: I am scheduled to see my GYN on 08/12/2021
CDC Split Type:

Write-up: I have been in menopause for 2 years. I have not had a period for those two years. I started post menopausal menstrual bleeding on 07/31/2021 which lasted for 5 days.


VAERS ID: 1540730 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: tri-lo-estarylla
Current Illness: none
Preexisting Conditions: none
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient complained of tingling on both legs lasting more than 6 days


VAERS ID: 1540779 (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: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Pain, 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: Elderberry vitamin supplement
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Within 7 hours I had fever of 101.3, chills, body aches. This lasted through the night but by the next morning my fever had broke and the body aches were gone.


VAERS ID: 1540921 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-26
Onset:2021-07-31
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Feeling abnormal, Pruritus, Rash, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (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: Paroxetine
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfur, metals can only wear pure gold or pure silver, hay allergies, dust
Diagnostic Lab Data: Waiting to see doctor
CDC Split Type:

Write-up: Extremely itchy rash over arms,chest, stomach,back,upper legs,butt, skin feels like I walked into spider webs naked and is itching everywhere. Very fine in some areas and hive like in other areas. Creams do not help and benadryl helps for short time. Have doctor''s appointment on Thursday 8/12/2021. I also have felt brain fog almost like a dazed feeling this comes and goes.


VAERS ID: 1544627 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Lymph Node Swelling-Medium


VAERS ID: 1545043 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04021A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Heart rate increased, Hypersensitivity, Impaired driving ability, Impaired work ability, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
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: vsafe

Write-up: 15 minutes after shot had severe throat swelling in left back side of throat, obstructing breathing, huge spike in heart rate. Extreme fatigue, shortness of breath, several days unable to drive to work. Contacted pharm tech and was advised to go to ER. Went to ER, had vitals taken, then treated for allergic reaction with prednazone and benadryl on IV drip. Prescribed prednazone for 3 days (3 times a day), and benadryl 50 grams for 3 days taken every 8 hours. Have fully recovered since then.


VAERS ID: 1545121 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Mother and daughter arrived at the pharmacy seeking a first Pfizer dose for the daughter. After returning the consent form with her daughter''s date of birth, making her an eligible 12 year old to receive the vaccine, we promptly administered the vaccine to the child. After mother and daughter left following her 15 minute observation period, the pharmacy staff discovered upon entering patient information into state''s immunization registry that the patient''s actual date of birth is incorrect. After calling and questioning the mother more, the mother did admit to lying on the consent form and that she did indeed change her daughter''s date of birth to make her eligible to receive the Pfizer vaccine. There has been no known adverse reaction to the daughter to date.


VAERS ID: 1545239 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Pain, Pain of skin, Peripheral coldness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Penicillin, mushrooms, penicillium, lactose.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA - approximately 11-12 hours after receiving the vaccine, I began to have severe body aches (felt like I''d been hit by a bus), skin sensitivity (meaning, my skin actually hurt without being touched), simultaneously had a fever while shivering uncontrollably with extremities that were freezing. Also had the symptoms of a panic attack, which may have been an actual manifestation of panic, or may have been related to the vaccine and simply mimicked a panic attack. Most of these symptoms resolved by mid-morning, but extreme fatigue continued throughout the next 2 days.


VAERS ID: 1545275 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-31
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Electrocardiogram abnormal, Immunoglobulin therapy, Loss of personal independence in daily activities, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Speech language delay
Allergies: nka
Diagnostic Lab Data: Results for patient as of 8/11/2021 11:15 7/30/2021 23:09 TROPONIN I: 7.81 (H) 7/31/2021 05:10 TROPONIN I: 15.81 (H) 7/31/2021 11:10 TROPONIN I: 9.16 (H) 7/31/2021 20:00 TROPONIN I: 6.28 (H) 8/1/2021 06:25 TROPONIN I: 8.93 (H) 8/2/2021 05:15 TROPONIN I: 7.44 (H) 8/3/2021 06:00 TROPONIN I: 1.36 (H) 8/3/2021 17:21 TROPONIN I: 0.76 (H) 8/5/2021 16:07 TROPONIN I: 0.23 (H)
CDC Split Type:

Write-up: 14y/o M received his 2nd dose of Pfizer COVID vaccine on 7/28 and started to complain of chest pain on 7/30. Pain worsened to 8/10 and he was seen in the ED that evening with an ECG suggestive of acute myopericarditis and positive troponin of 7.81. He was admitted for likely post-covid vaccine myopericarditis. His was initially treated with ibuprofen overnight with no complains of chest pain the following morning 7/31, and continued to be asymptomatic throughout the rest of his hospital course. Troponin on 7/31 AM was up to 15.81. An echo was completed and showed normal cardiac size and function without pericardial effusion. He was acutely treated with IVIG continuously for for 9 hours, and Ibuprofen q8 hour for a total of 4 days. Troponin was trended daily with gradual improvement to 1.36 on morning of discharge. A repeat echo was performed that was normal. Given that a repeat troponin level on 8/3 PM was 0.76, he was deemed to be stable for discharge by Pediatric Cardiology. He will need to be restricted from strenuous activities with no competitive sports or physical education for 3 months per cardiology. Pediatric Cardiology will continue to follow him as an outpatient, monitoring him 2-day post-discharge troponin level and will perform an exercise stress test in 3 months. Discharged on 7 more days of Motrin TID w meals


VAERS ID: 1545339 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-01
Onset:2021-07-31
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: zoloft, wellbutrin, zyrtec
Current Illness:
Preexisting Conditions:
Allergies: diflucan
Diagnostic Lab Data: Positive Covid/SARS testing on 8/3/2021
CDC Split Type:

Write-up: I tested positive for Covid/SARS on 8/3/2021 after successfully completing both vaccinations on schedule.


VAERS ID: 1545608 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Bladder catheterisation, Blood test, Blood urine present, Constipation, Culture urine, Dysuria, Feeling abnormal, Impaired work ability, Neurogenic bladder, Pain, Pelvic pain, Pyrexia, Urinary retention, Urine analysis, White blood cell count increased, X-ray
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: It started with severe back pain the day following my injection. I began taking Tylenol. Still wasn?t feeling quite right, and I started to run a fever on Monday evening 8/2/21. I was out of work 8/2/21 and 8/3/21 with fever and body aches. Went to medical facility on 8/3/21 was Covid tested and advised that my symptoms were a ?normal? reaction to vaccine. Returned to work on 8/4/21 with persistent low back pain and pelvic pain. Began having difficulty with urination on 8/7/21. At that same time became extremely constipated. Went back to medical facility on 8/8/21, was advised of trace blood and trace leukocytes in my urine. Was told that it wasn?t enough to treat. Went to work on 8/9/21, I advised doctor, who I work for and she is my gynecologist, that I had not urinated since 8/8/21 and something was not right. She placed a catheter and removed over 800 cc of urine from my bladder. Urine dip did now show any signs of infection. Urine culture was sent to lab. Was sent home from work with Bactrim DS. Was still unable to urinate on my own at 4:00pm. Was advised to go to ER. Waited 3 hours at medical facility and couldn?t wait anymore. Went to another medical facility on 8/9/21. Foley catheter was placed, blood drawn, and X-rays taken. Was sent home with Foley catheter in place. Saw a doctor on 8/10/21 and diagnosed with neurogenic bladder.


VAERS ID: 1545651 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Muscle spasms, Pain in extremity, Paraesthesia oral, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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: none
Current Illness: none
Preexisting Conditions: None
Allergies: Amoxicillin, omnicef, percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itching all over body and tingling of lower lip. Hives all over top half of back within the first four hours of injection. Headaches for three days and off an on for a week after that. Leg pain and cramping of both legs for over a week and still going on.


VAERS ID: 1546706 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

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

Write-up: Extreme tinnitus developed 48 hours after first shot. ENT doctor prescribing prednisone.


VAERS ID: 1547469 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-31
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature abnormal, Headache, Malaise, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210815568

Write-up: NO TEMPERATURE SINCE YESTERDAY; SO UNWELL; ARM IS STILL REALLY SORE; NAUSEA; HEADACHE; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 31-JUL-2021, the patient experienced so unwell. On 31-JUL-2021, the patient experienced arm is still really sore. On 31-JUL-2021, the patient experienced nausea. On 31-JUL-2021, the patient experienced headache. On 31-JUL-2021, the patient experienced no temperature since yesterday. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from no temperature since yesterday on 05-AUG-2021, and had not recovered from so unwell, arm is still really sore, nausea, and headache. This report was non-serious.


VAERS ID: 1548788 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: Pt developed a red ring around the injection site


VAERS ID: 1549095 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

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

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

Write-up: I was looking through the vaccinated list and there was an individual who received a 3rd dose of Moderna on 7/31. This individual did list ?No? to the question of if this was their first vaccine dose when they registered on-site.


VAERS ID: 1549248 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-17
Onset:2021-07-31
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Cough, Diarrhoea, Fatigue, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allopurinol, carvedilol, clopidogrel, furosemide, pregabalin,
Current Illness: defied
Preexisting Conditions: CHF, Gout
Allergies: Lortab, Vicodin
Diagnostic Lab Data: SARS CoV2 PCR COVID19 positive on 8/1/2021
CDC Split Type:

Write-up: Patient experienced one week of diarrhea, abdominal pain, fatigue, and cough for 2 weeks. She came to ED on 7/31/2021 and tested positive COVID PCR. She was hospitalized on 7/31/2021. She also stated her husband is currently hospitalized for Covid. Note: patient completed the series of COVID19 Pfizer vaccines in Feb, 2021. 8/4/21: patient discharged.


VAERS ID: 1549271 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-06
Onset:2021-07-31
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Bronchitis, COVID-19, Dyspnoea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen, albuterol-ipratropium, aspirin, cholecalciferol; dexamethasone, diltiazem, losartan-chlorothiazide, multivitamin with minerals, nystatin oral susp, omeprazole, ubiquinone
Current Illness:
Preexisting Conditions: COPD, Asthma, Hypothyroidism, Afib, Depression
Allergies: Iodine, Latex
Diagnostic Lab Data: Reported outpatient COVID test was positive on 7/23/21 (not tested at 1st Hospital)
CDC Split Type:

Write-up: Patient was diagnosed bronchitis and given antibiotics by her primary and pulmonologist as an outpatient. She was tested positive for COVID on 7/23/21, and she received Regeneron on 7/29/21. She came to ED with worsening shortness of breath with low grade fever on 7/31/21 and was hospitalized for further management. 8/10/2021: patient transferred to another hospital 8/12/2021: patient still admitted at the time of this report submission Note: patient completed Pfizer vaccines (02/13/21 and 03/06/21).


VAERS ID: 1549296 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 1 LA / IM

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

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

Write-up: 4-5 inches of redness around injections site


VAERS ID: 1549409 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-24
Onset:2021-07-31
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cerebral thrombosis, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Haemorrhagic cerebral infarction, Haemorrhagic transformation stroke, Magnetic resonance imaging head abnormal, Mechanical ventilation, Mental status changes, Venogram abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Respiratory failure (broad)

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine, Lipitor
Current Illness:
Preexisting Conditions: Hypothyroidism, Hyperlipidemia
Allergies: None
Diagnostic Lab Data: Brain MR Venogram without contrast : August 6 -2021: No Flow in the Left Sigmoid sinus or left jugular vein bulb. Thrombosis cannot be excluded. Diminutive Left Transverse Sinus MRI Head with and without contrast: August-6-2021: Multifocal Bilateral Infarcts with Hemorrhagic Conversion of infarction of the right frontal, right parietal, right periventricular and left parietal region.
CDC Split Type:

Write-up: Patient developed altered mental status, weakness. Her CT scan showed infarcts and hemorrhage. She required mechanical ventilation. Her MRI venogram of brain showed cerebral venous and sinus thrombosis. She was referred for Mechanical thrombectomy to another institution.


VAERS ID: 1549460 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Electrocardiogram, Fatigue, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Ergocalciferal, 50,000 IU weekly for 6 weeks total, Topical benzaclin for acne
Current Illness: None Known
Preexisting Conditions: Vitamin D Insufficiency
Allergies: None Known
Diagnostic Lab Data: EKG ordered on 8/12/21 and results pending
CDC Split Type:

Write-up: Patient reports left sided chest pain and pressure with heart racing shortly after the vaccine. Reports also feeling fatigue. Symptoms lasted 3-4 days. Pain reported as a 5 out of 10. Left side of chest. Did not seek medical attention at the time and symptoms have completely resolved


VAERS ID: 1549537 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -

Administered by: Public       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 had syncopal episode within 10 minutes of vaccination. Patient felt better after drinking some water and was released to home.


VAERS ID: 1549605 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

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

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

Write-up: Pt made an appointment through portal to get her COVID shot on 7/31/2021. When filling out the questionnaire she attested that she had not received a COVID shot. When patient came to pharmacy to get her shot, we printed voucher and she signed it again attesting that she had not received a COVID shot. We administered the Pfizer Vaccine(1st dose). After administration we entered the immunization record into the system. It was there that we discovered that patient had received Johnson and Johnson vaccine on 4/6/2021 at another Pharmacy.


VAERS ID: 1549677 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-28
Onset:2021-07-31
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 03/7/21pfizer,Lot#EN 6205 2nd dose 03/28/21Pfizer,lot#ER8733 Diagnosed covid positive:08/02/21 Symptom onset:07/31/21 Exposure:Travel Symptoms:muscle aches,headache , fatigue


VAERS ID: 1549688 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-29
Onset:2021-07-31
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, Fatigue, Nausea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/08/21pfizer,Lot#EL3248 2nd dose 01/29/21,Pfizer,lot#EN5318 Diagnosed covid positive:08/02/21 Symptom onset:07/31/21 Exposure:unknown Symptoms:cough, fatigue, nausea, diarrhea.


VAERS ID: 1549707 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-07-27
Onset:2021-07-31
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dermatitis allergic, Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Allergic skin reaction (erythema multiforme) on inner biceps, upper thighs, entire rear thighs, and waistline.


VAERS ID: 1550429 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LIOTHYRONINE 5 MCG, LEVOTHYROXINE 175 MCG
Current Illness: NONE
Preexisting Conditions: HYPOTHYROID
Allergies: NKA
Diagnostic Lab Data: ADVISED PATIENT TO GO TO ER AS IT COULD BE A BLOOD CLOT.
CDC Split Type:

Write-up: PATIENT CALLED ON 08/12/2021 INFORMING SHE HAS AN HEADACHE EVER SINCE SHE RECEIVED THE VACCINE.


VAERS ID: 1553687 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-27
Onset:2021-07-31
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hives - Started on the trunk of his body. He is still having hives on his upper arms and legs. The hives on his back and torso do look like they are beginning to fade.
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives, starting on back and torso, causing great discomfort - itching


VAERS ID: 1553799 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-10
Onset:2021-07-31
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, Chest pain, Laboratory test abnormal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CAD s/p PCI, STEMI 06/23/2021, chronic pain on narcotics, hypertension, hyperlipidemia, diabetes
Allergies: dulaudid
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient presents with chest pain. The onset was 12 hours ago. Radiation none. Movement none. Associated symptoms: none. The course/duration of symptoms is constant. Location: Left anterior chest. The character of symptoms is sharp and stabbing. The degree at onset was moderate. The degree at maximum was moderate. The degree at present is moderate. Exacerbating factors consist of none. The relieving factor is none. Prior episodes: angina. Additional history: 57-year-old female presents ED with chief complaint of chest pain. Patient states began roughly 12 hours ago. Located left side of chest. Sharp in nature. It is also stabbing. It does not radiate. It is made better by nothing. It is made worse by nothing. Denies any fevers or chills but states she was told she had a fever when she checked into the emergency department. Denies any numbness or tingling. Patient states she had a "heart attack in January. " Patient states she has been seen in the hospital numerous times for chest pain but everything is been negative. Review of records show that it was June when the patient was seen and had stents placed. Denies any urinary symptoms. Denies abdominal pain. No other complaints at this time. 7/31/2021 tested positive 8/6/2021 patient discharged.


VAERS ID: 1554194 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 reports rash on front of both lower legs and stomach the day after receiving second dose of Pfizer vaccine. Treating with topical hydrocortisone cream.


VAERS ID: 1554286 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-07-31
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK - / -

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

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

Write-up: I63.9 - Stroke determined by clinical assessment I63.9 - Acute CVA (cerebrovascular accident) N17.9 - Acute kidney failure, unspecified R29.810 - Facial weakness


VAERS ID: 1554506 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-26
Onset:2021-07-31
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM 9809 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6203 / 2 LA / IM

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

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

Write-up: 2nd dose on 2/26/2021. Then admitted to hospital on 7/31/2021. Currently still in hospital in regular nursing floor. Unable to reach family for status update


VAERS ID: 1558153 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Conjunctival haemorrhage, Fatigue, Pain, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Conjunctival disorders (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Moderate deltoid soreness, Body aches and fatigue for around 12 hours. Bilateral sub conjunctival hemorrhage.


VAERS ID: 1558182 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Oligomenorrhoea, Pregnancy test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Normal pregnancy conditions and outcomes (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taking Lo Loestrin but stopped two days prior to vaccination (end of pack)
Current Illness: None.
Preexisting Conditions: Asthma
Allergies: Cephalosporins
Diagnostic Lab Data: Negative pregnancy tests
CDC Split Type:

Write-up: My period is absent. The first period after dose one was horrible. I bled more than I have ever bled in my life. I took pictures of the blood running down my leg half an hour after changing a pad because I was so scared. I was prepared to experience another heavy cycle after dose 2, but instead my period never came. I have taken two pregnancy tests. I am not pregnant. I have never missed a period except for during my only pregnancy and during breastfeeding. I have not missed a period since weaning (11 years ago). It is a terrible feeling not knowing why your period won''t come.


VAERS ID: 1558340 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vertigo, Vestibular disorder
SMQs:, Vestibular disorders (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: Nuts, penicillin, potato, mushrooms, and more (food allergies usually onset by stress)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Mild vestibular issues (the spins when turning my head) Began about 2 days after vaccination (7/29 vax date), still occurring (as of 8/14)


VAERS ID: 1558434 (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: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Mobility decreased, Nausea, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 7/11/2021 extreme fatigue
Other Medications: Birth control
Current Illness: Na
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm was extremely sore the first day (couldn?t move my arm for a day and a half). The next day I became very nauseous. I took acetaminophen when I woke up the next morning and vomited within 15 minutes. I tried to sleep and rest as much as possible. At lunch time I ate and took acetaminophen and again vomited with 15 minutes. I didn?t eat until the evening and did not take any medication. The following morning (2 days after the vaccine), I felt better but my arm was still a little sore. I was also very fatigued during this time.


VAERS ID: 1558467 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Dizziness, Headache, Heart rate increased, Loss of consciousness, Malaise, Nervousness, Pain
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), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: MenB meningitis B shot - 105 fever/emergency room, approx age 45. Approx date given 8/2016 DTAP booster - prolonged hard raised
Other Medications: multi-vitamin, aspirin 81 mg
Current Illness: None
Preexisting Conditions: Hashimotos, overweight
Allergies: macrobid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within minutes I became very dizzy and started to black out. My heart also started to flutter and beat quickly. My head also felt like it was growing like a balloon. The dizziness and heart fluttering subsided after a minute or two and then started again a few minutes later. This happened a few times. I focused on a video game and also talked to a person waiting for their shot. I stayed for about a half hour because I was afraid I was going to pass out if I stood up. The pharmacist was busy and waved me to go probably after about 15-20 minutes. I did not tell the pharmacist how I was feeling because I was embarrassed and I just wanted to leave. I was sick the rest of the day with common symptoms like aches and headache, and one or two more heart flutters but no more dizziness at home. I am afraid now to get the second dose in fear of worse happening, so I am reporting this and will likely not get the second dose although I am nervous about not getting it.


VAERS ID: 1562834 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 3 LA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1569125 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

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

Write-up: On 7/31/21 patient made an appointment to get a COVID vaccine at our pharmacy. When filling out the screening questions he indicated he had never received a COVID vaccine. That same day he came to our pharmacy and we printed the Voucher from our appointment scheduler. We had him read over questions again and sign. For a second time he attested that he had never received a COVID vaccine. We administered the Pfizer vaccine to him on that day. After administration we entered his information on database. It was then that we discovered he had received the Johnson and Johnson vaccine on 4/6/2. I immediately called patient and questioned him about this. He denied ever receiving the J & J vaccine. I then called the other facility and they confirmed that he did receive J&J vaccine on 4/6/21.


VAERS ID: 1570764 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A / 1 OT / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Cardiac flutter, Chest discomfort, Fatigue
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Guillain-Barre syndrome (broad), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: uknown
Current Illness: unknown
Preexisting Conditions: type 2 diabetes mellitus hypertension overweight hyperlipidemia
Allergies: no known allergies
Diagnostic Lab Data: pt did not choose to get recommended work up as suggested by provider during appointment
CDC Split Type:

Write-up: She shares symptoms started 5-6 hours later post date of vaccination (7/31/2021).She notes that her chest felt like a squeezing, pulling sensation. She shares her heart felt like a flutter or "flopping sensation". Pt share she was laying on her bed, then she thinks she fell asleep. When she woke up she could walk and function normally. She also admits to fatigue, weakness.


VAERS ID: 1570770 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood glucose normal, Blood sodium normal, Chest X-ray normal, Differential white blood cell count, Dizziness, Electrocardiogram P wave normal, Electrocardiogram PR interval, Electrocardiogram QT interval, Electrocardiogram ST segment normal, Electrocardiogram T wave normal, Feeling hot, Full blood count, Glomerular filtration rate, Headache, Inappropriate schedule of product administration, Metabolic function test, Nausea, Neutrophil count, Pregnancy test, Pregnancy test negative, QRS axis, QRS axis abnormal, Sensory disturbance, Sinus rhythm, Vaccination complication
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet cetirizine (ZYRTEC) 10 MG tablet fluticasone-vilanterol (BREO ELLIPTA) 200-25 MCG/INH inhaler glucosamine hcl 1000 MG tablet hydroCHLOROthiazide 25 MG tablet hydrOXYzine hcl 25 MG tablet ipratropium-alb
Current Illness: N/A
Preexisting Conditions: Cardiovascular and Mediastinum Migraine Essential hypertension Dermatologic Rosacea Endocrine IFG (impaired fasting glucose) Musculoskeletal DDD (degenerative disc disease), lumbar Achilles tendinitis of left lower extremity Bunion of great toe of right foot Ophthalmologic Myopia of both eyes with regular astigmatism and presbyopia Other Depression History of breast cancer - left breast in situ (6/23/2020)
Allergies: Latex-Swelling Adhesive Tape [Tape]-Rash Nickel-Rash Peppermint Oil-Rash SeasonalRunny Nose Sulfa- DrugsItching
Diagnostic Lab Data: 7/31/2021 ED visit: Labs Reviewed COMPREHENSIVE METABOLIC PANEL (CPANEL) - Abnormal; Notable for the following components: Result Value GLUCOSE RANDOM 132 (*) SODIUM 136 (*) All other components within normal limits CBC WITH DIFF - Abnormal; Notable for the following components: ABSOLUTE NEUTROPHILS 8.0 (*) All other components within normal limits TROPONIN I SERUM PREGNANCY QUAL GFR--ESTIMATED GLOMERULAR FILTRATION RATE TROPONIN I Imaging XRAY CHEST AP PORTABLE Result Date: 7/31/2021 No active disease of the chest. Reading Radiologist - Dictation Date Time - 07/31/2021 21:09 CDT Signed Date Time - 07/31/2021 21:09 CDT Transcriptionist - NA CT HEAD W/O IV CONTR Result Date: 7/31/2021 * No acute intracranial findings. Reading Radiologist - Dictation Date Time - 07/31/2021 21:29 CDT Signed Date Time - 07/31/2021 21:32 CDT Transcriptionist - NA Medications acetaminophen (TYLENOL) tablet 1,000 mg (1,000 mg Oral Not Given 7/31/21 1951) sodium chloride IV bolus 0.9 % 1,000 mL (0 mL Intravenous Infusion Complete 7/31/21 2150) ketorolac (TORADOL) injection 15 mg (15 mg Intravenous Given 7/31/21 2026) prochlorperazine (COMPAZINE) injection 10 mg (10 mg Intravenous Given 7/31/21 2042) EKG 7/31/2021 at 2125 Normal sinus rhythm at 69 bpm Normal P waves, PR interval, QTc, QRS, axis Poor R wave progression No definitely new concerning ST or T-wave changes
CDC Split Type:

Write-up: Patient received care at ED on 7/21/2021: Reports she got her 2nd dose of pfizer vaccine yesterday. Had similar reaction to the first dose but back in December. Waited for second one due to first dose. Having all over weakness, HA. Also having dizziness. An 8/10 HA. Nauseated as well. Also had weird sensation over the R side of her face feeling very warm like she was on a heating pad. Symptoms started at 10pm last night. Just doesn''t feel like she is getting any better. DDx considered includes but not limited to: myositis, active infxn, intra-cranial abnl. W/u for these is reassuring against emergent pathology. Most likely related to 2nd vaccine dose. Disposition: Discharge


VAERS ID: 1573902 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-30
Onset:2021-07-31
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Heavy menstrual bleeding, Mood swings, Muscle spasms
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Dystonia (broad), Depression (excl suicide and self injury) (broad)

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

Write-up: Headache for 3 days straight after 2nd dose. Very heavy bleeding during period - very intense pre-menstral symptoms including - mood swings for a week and cramps like I?m in labor before period arrives.


VAERS ID: 1574402 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Axillary pain
SMQs:, Guillain-Barre 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: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe L armpit pain, Weakness


VAERS ID: 1574453 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Heart rate increased, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: fastened heart beat; swollen right eye (looked like got beaten) low fever these duration last one day and recovered
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: low fever; swollen right eye ,fastened heartbeat ; no treatment


VAERS ID: 1574481 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 RA / IM

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

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

Write-up: Patient fainted about 5-10 minutes post vaccination. EMT was summoned and patient was taken to near by hospital.


VAERS ID: 1574601 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-17
Onset:2021-07-31
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Blood glucose increased, COVID-19, Chest X-ray abnormal, Cough, Dyspnoea, Lung infiltration, Lung opacity, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: pyloric stenosis
Allergies: NKA
Diagnostic Lab Data: 7/31/2021: CXR: bilateral perihilar ground glass and airspace pulmonary infiltrate Covid-19 positive by PCR
CDC Split Type:

Write-up: Admitted to hospital on 7/31/2021 with SOB, cough and loss of taste and smell. Blood sugar 370 with no known history of diabetes. He had known exposures to Covid 19. Treatment recommendations indicated: remdesivir -Dexamethasone per the protocol which is 10 mg daily for 3 days followed by 6 mg daily for 7 days -Dose of every 200 mg x 1 followed by 100 mg x 4 days. Submitter does not have access to further follow up information on this client. Please contact hospital indicated for further medical records.


VAERS ID: 1577510 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-07-31
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Body temperature, Decreased appetite, Diarrhoea, Dizziness, Hypotension, Inadequate diet, Lethargy, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Lung cancer; Peripheral arterial disease; Seasonal allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Back surgery (9 hour back surgery); Hernia repair; Lung lobectomy (top part of lung was removed because of lung cancer.); Tubal ligation (46 years ago); Comments: Patient had Imder allergy.
Allergies:
Diagnostic Lab Data: Test Date: 20210731; Test Name: Body temperature; Result Unstructured Data: 102.1
CDC Split Type: USJNJFOC20210827145

Write-up: LOW BLOOD PRESSURE; STOMACH HURTING; DIZZINESS; LETHARGY; NOT EATING WELL; NO APPETITE; DIARRHEA; WEAK; HIGH TEMPERATURE OF 102.1; This spontaneous report received from a consumer concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: lung surgery, hernia surgery, tied tubes, and back surgery, and concurrent conditions included: peripheral artery disease, lung cancer, and seasonal allergy, and other pre-existing medical conditions included: Patient had Imder allergy. The patient experienced drug allergy when treated with clotrimazole, oxycodone hydrochloride/paracetamol, and simvastatin. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 31-JUL-2021, the patient experienced low blood pressure. On 31-JUL-2021, the patient experienced stomach hurting. On 31-JUL-2021, the patient experienced dizziness. On 31-JUL-2021, the patient experienced lethargy. On 31-JUL-2021, the patient experienced not eating well. On 31-JUL-2021, the patient experienced no appetite. On 31-JUL-2021, the patient experienced diarrhea. On 31-JUL-2021, the patient experienced weak. On 31-JUL-2021, the patient experienced high temperature of 102.1. Laboratory data included: Body temperature (NR: not provided) 102.1. The action taken with covid-19 vaccine was not applicable. The outcome of the diarrhea, stomach hurting, low blood pressure, high temperature of 102.1, dizziness, lethargy, not eating well, weak and no appetite was not reported. This report was non-serious. This case, involving the same patient is linked to 20210826468.


VAERS ID: 1578008 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-30
Onset:2021-07-31
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Nausea, SARS-CoV-2 test positive, Upper respiratory tract infection
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Outpatient Medications ACCU-CHEK FASTCLIX LANCET DRUM misc acetaminophen 500 mg capsule acyclovir (ZOVIRAX) 400 mg tablet azaTHIOprine (IMURAN) 50 mg tablet betamethasone, augmented, (DIPROLENE) 0.05 % ointment buPROPion SR (WELLBUTRIN SR)
Current Illness:
Preexisting Conditions: Nervous Neuropathy Migraine headache Tinnitus Headache Diabetic polyneuropathy associated with type 2 diabetes mellitus Chest pain, unspecified type Respiratory Allergic rhinitis Sinus congestion Circulatory Hypertension associated with diabetes PAN (polyarteritis nodosa) Nonischemic cardiomyopathy Chronic systolic heart failure Nonsustained paroxysmal supraventricular tachycardia Abnormal nuclear stress test Digestive GERD (gastroesophageal reflux disease) Irritable bowel syndrome Class 3 severe obesity due to excess calories with serious comorbidity and body mass index (BMI) of 40.0 to 44.9 in adult Non-intractable cyclical vomiting with nausea Dysphagia, unspecified type Vitamin D deficiency Genitourinary Cyst of right ovary Urinary incontinence Post-menopausal Musculoskeletal Tinea of perianal region Tinea cruris Pressure ulcer of coccygeal region, stage 3 Endocrine/Metabolic Hypercholesterolemia Hypokalemia Hypocalcemia Type 2 diabetes mellitus with hyperglycemia, with long-term current use of insulin Hyperlipidemia associated with type 2 diabetes mellitus Other Ataxia Chronic disorganized schizophrenia Hypersomnia Insulin long-term use Pyuria Primary hypersomnia Vertigo Neuroma Dizziness Disorganized schizophrenia Elevated alkaline phosphatase level Hypersomnia Encounter for long-term (current) use of medications
Allergies: Atarax [Hydroxyzine Hcl]Hallucinations Haldol [Haloperidol]Swelling PravastatinMyalgia / Muscle Pain Sulfa (Sulfonamide Antibiotics)Rash, Other (document details in comments) AcetazolamideRash Bee Venom Protein (Honey Bee)Other (document details in comments) CodeineRash DoxycyclineDiarrhea, Other (document details in comments), Nausea and Vomiting HydrochlorothiazideOther (document details in comments) IbuprofenOther (document details in comments) LevofloxacinOther (document details in comments) MetoclopramideOther (document details in comments) MoldIndigestion / GI upset Nsaids (Non-steroidal Anti-inflammatory Drug)Other (document details in comments) PromethazineOther (document details in comments) Sulfamethoxazole-trimethoprimRash Trulicity [Dulaglutide]Dizziness / Lightheaded
Diagnostic Lab Data: 08/02/21 1337 POCT COVID-19 PCR Collected: 08/02/21 1337 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000268759 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 5/29/22
CDC Split Type:

Write-up: Contact with and (suspected) exposure to covid-19 Acute upper respiratory infection Nausea


VAERS ID: 1578019 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-18
Onset:2021-07-31
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 RNA
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler aspirin 81 mg chewable tablet atorvastatin (LIPITOR) 80 mg tablet buPROPion XL (WELLBUTRIN XL) 150 mg 24 hr tablet busPIRone (BUSPAR) 10 mg tablet citalopram (CeleXA) 40 mg tablet(Expire
Current Illness:
Preexisting Conditions: Nervous Abdominal pain, acute, right lower quadrant Chest pain Low back pain Lower extremity pain Multiple joint pain Nicotine dependence, cigarettes, in remission Sacroiliac joint pain Upper extremity pain Circulatory Palpitations TIA (transient ischemic attack) Digestive Obesity Genitourinary Irregular periods Vaginal dryness Musculoskeletal Lower extremity weakness Rash, skin Spasm of muscle, back Weakness of both upper extremities Injury of arm, left, subsequent encounter Laceration of left forearm Cellulitis of left arm Arm laceration, left, initial encounter Endocrine/Metabolic Elevated blood sugar High triglycerides Type 2 diabetes mellitus without complication, without long-term current use of insulin Other Anxiety Depression Genetic disorder PMDD (premenstrual dysphoric disorder) Elevated glucose
Allergies: DuloxetineDiarrhea
Diagnostic Lab Data: 08/03/21 0114 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/02/21 1850 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/03/21 0114 COVID-19 PCR Collected: 08/02/21 1850 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Fever or Chills Muscle or body aches Headache Sore throat Congestion or running nose


VAERS ID: 1578107 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Decreased appetite, Fatigue, Headache, Menstruation irregular, Pain, Pyrexia, Rhinitis allergic, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Took Advil after vaccination as symptoms came
Current Illness: A cold about a month prior, confirmed not covid
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Two Minute Clinic visits (8/14 & 8/15) did not run any tests, but the doctors thought the symptoms were not concerning and advised to watch for increased bleeding and persistent symptoms.
CDC Split Type:

Write-up: Fever fluctuating between 100-103 degrees for one week, fatigue, headache, loss of appetite, nausea with two vomiting episodes (day 3 and day 5), body aches, continued nausea, loss of appetite, and stomach heavyness for about 5 days after the first week. Nausea, appetite, and stomach improved by 15 days after the second dose. Irregular vaginal bleeding began occurring on day 13 since the dose, and has continued for 4 days (current).


VAERS ID: 1578136 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-14
Onset:2021-07-31
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, COVID-19, Cardiac murmur, Chest pain, Computerised tomogram thorax abnormal, Diarrhoea, Dyspnoea, Ex-tobacco user, Exposure to SARS-CoV-2, Haemoptysis, Headache, Hypertension, Lung consolidation, Pain, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Scan with contrast
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler aspirin 81 mg tablet hyoscyamine (LEVBID) 0.375 mg 12 hr tablet valACYclovir (VALTREX) 500 mg tablet
Current Illness:
Preexisting Conditions: Nervous Peroneal nerve injury Morton''s neuroma of left foot Foot pain Cubital tunnel syndrome Complex regional pain syndrome Respiratory Chronic obstructive lung disease (CMS/HCC) Allergic rhinitis Other nonspecific abnormal finding of lung field Circulatory Mitral valve disorder Genitourinary Chronic interstitial cystitis Musculoskeletal Snapping hip syndrome Pes equinus, acquired Leg swelling Internal derangement of knee Herniated cervical disc Cellulitis and abscess of finger Bursitis of right hip Hematologic APS (antiphospholipid syndrome) (CMS/HCC) Infectious/Inflammatory Herpes zoster Other Prolonged depressive adjustment reaction Depression Acute stress disorder
Allergies: Varenicline Alprazolam Gabapentin Nitrofurantoin Monohyd/m-cryst Penicillins
Diagnostic Lab Data: 08/08/21 1428 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/07/21 1025 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/08/21 1428 COVID-19 PCR Collected: 08/07/21 1025 | Final result | Specimen: Swab from Nares Procedure Component Value Ref Range Date/Time CT angiogram chest with and without contrast [3297418441] Resulted: 08/12/21 1214 Order Status: Completed Updated: 08/12/21 1214 Narrative: CT ANGIOGRAM CHEST W WO CONTRAST IMPRESSION: No CT evidence for pulmonary emboli Focal area of consolidated lung demonstrated in the right upper lobe anteriorly. This is present on prior exam 3/18/2017 but is more prominent on the present exam with associated bronchial wall thickening suggestive of inflammatory infectious process and a small pneumonia may be present in this area. END OF IMPRESSION: INDICATION: pe. TECHNIQUE: Using CT angiogram (pulmonary embolism) technique, axial and reformatted coronal and sagittal images were obtained from the diaphragm to the lung apex following intravenous contrast. 3D postprocessing images were obtained on an independent workstation. CONTRAST: 100mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Up-to-date CT equipment and radiation dose reduction techniques were employed. CTDIvol: 5.3 - 13.7 mGy. DLP: 236 mGy-cm. . COMPARISON: Thoracic CT 3/8/2017 FINDINGS: Diagnostic quality: Adequate Pulmonary embolism: There is no evidence for pulmonary emboli. Hila, mediastinum, aorta and heart: Normal. Calcified granuloma right hilum right lower lobe Upper abdomen: Prior cholecystectomy. Lung parenchyma and pleura: There is a focal area of consolidation seen in the anterior right upper lobe best identified on image 98 series 4. This is worsened compared with the prior study 2017. There is associated bronchial wall thickening seen in the right anterior mid thorax on a image 87 series 4 minimal atelectatic changes seen in the lingula. Bones: Normal. Breast implants present
CDC Split Type:

Write-up: Shortness of Breath Muscle or body aches Headache ED Discharged 8/12/2021 (3 hours) Emergency Room Chief Complaint Patient presents with ? Shortness of Breath ? Chest Pain Patient presents emergency room today for ongoing chest pain and shortness of breath associated with COVID-19. Patient states she started with diarrhea late last week that progressed to cough and shortness of breath with associated fever. She was tested for Covid on Saturday and came back positive. She has had several positive Covid exposures. She is vaccinated for COVID-19. She states that today she has had increasing chest pain on the right side with some hemoptysis. She has ongoing fever. She has been using her inhaler and steroids as directed. Patient is normally healthy and does not take any medications on a daily basis. She is being monitored for increasing hypertension as well as a murmur from a valve issue. Patient states her temperatures been as high as 102. She has been using Tylenol for her fever. Patient denies any history of high cholesterol or diabetes. She has no significant direct family history of coronary artery disease. Patient is a former smoker.


VAERS ID: 1578193 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-04
Onset:2021-07-31
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Mechanical ventilation
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient hospitalized and on ventilator due to COVID-19. Patient is fully vaccinated.


VAERS ID: 1578626 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chills, Computerised tomogram normal, Electrocardiogram abnormal, Fibrin D dimer increased, Headache, Hypertension, Pyrexia, Tachycardia
SMQs:, Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Amlodpine 5mg tablet- One tablet daily
Current Illness: None
Preexisting Conditions: Kidney disease
Allergies: NKA
Diagnostic Lab Data: EKG was performed and confirmed tachycardia (no other abnormalities) as well as blood pressure taken which showed severe hypertension. Blood test showed D-dimer elevated in which emergency room provider thought possible PE. CT was done and showed no evidence of such.
CDC Split Type:

Write-up: Extreme headache, chills, with fever. Fever reached 103.0 degrees fahrenheit in which I self medicated with Tylenol and cold compress/wash clothes. I then became severely hypertensive with tachycardia and presented to the ER on 8/3/2021.


VAERS ID: 1578996 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1085 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Feeling abnormal, Mobility decreased
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: patient had chills, extreme fatigue unable to get out of bed for 13 days, dizziness/lightheadedness, brain fog


VAERS ID: 1582127 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-07-31
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Chest discomfort
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Systemic: Abdominal Pain-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Additional Details: Patient states 4 days after 1st dose of pfizer shot she started having chest pain and stomach upset- i reffered her to her PCP and recommended that gets diagnosed before we do the second shot that is scheduled today on 8/17/21


VAERS ID: 1582164 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EC3180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Chest pain, Dizziness, Feeling abnormal, Feeling jittery, Headache, Nausea, Pain in extremity, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diclofenac Sodium Nexium Paxil Zonisamide Horizant Creator Zanaflex Hydrocodone Women?s daily multivitamin Vitamin D3 Quercetin & Bromelain
Current Illness:
Preexisting Conditions: Chronic back pain - herniated discs Fibromyalgia Migraines High cholesterol
Allergies: None
Diagnostic Lab Data: 7/31/21 Allergic reaction cocktail of meds. Medication administered through IV: Benadryl Toradol Decadron Zofran
CDC Split Type:

Write-up: Within 20 to 25 minutes, felt pain sensation going down left arm from side of injection to elbow. Shortly after, sensation went up to shoulder above shoulder blade. Next, began having weird sensation throughout upper body and started to feel the need to breathe deeply. Sensation later felt like jittery feelings as if blood sugar had dropped and I felt shaky all in my arms.Next began to feel foggy brained like I could not concentrate and think of what I was trying to say. Got out of car, stood up and felt nauseated and dizzy headed. This was now approximately 45 minutes after injection. Next, just began to burn right and center of breastbone, just as it did when I had Covid. Began to realize all symptoms that experience during Covid we?re hitting me in less than one hour after vaccine. Went to ER to get checked out, to be on the safe side since pain was near heart and in chest. Then headache started and lasted for two days. Headache was also last symptom toDissipate from Covid last year.


VAERS ID: 1582315 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Asthenia, COVID-19, Dehydration, Diarrhoea, Hypocalcaemia, Hypokalaemia, Hypomagnesaemia, Hypoxia, SARS-CoV-2 test positive, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (narrow), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet atorvastatin (LIPITOR) 40 mg tablet azelastine (ASTELIN) 137 mcg (0.1 %) nasal spray diclofenac (VOLTAREN) 50 mg EC tablet fluticasone HFA (FLOVENT
Current Illness:
Preexisting Conditions: Nervous Bilateral cataracts Respiratory Allergic rhinitis Intermittent asthma Obstructive sleep apnea Circulatory Benign essential hypertension Digestive Adenomatous polyp of colon Duodenitis Musculoskeletal Degeneration of cervical intervertebral disc OA (osteoarthritis) of knee Osteoarthritis of shoulder Osteopenia Rosacea Endocrine/Metabolic Multiple thyroid nodules Other Breast cyst Depression Advanced directives, counseling/discussion Anxiety Psychophysiological insomnia
Allergies: FluoxetineMental Status Change Mirtazapine AcyclovirDiarrhea, Nausea and Vomiting AlbuterolNausea and Vomiting BupropionAnxiety BuspironeOther (document details in comments) ClomipramineOther (document details in comments) DuloxetineOther (document details in comments) Erythromycin BaseNausea Only MetforminDiarrhea NortriptylineOther (document details in comments) ParoxetineOther (document details in comments) TrazodoneNausea and Vomiting VilazodoneOther (document details in comments
Diagnostic Lab Data: Updated Procedure 08/11/21 1811 COVID-19 EXTERNAL (NON WELLSPAN OR NON INTERFACED LAB) Collected: 08/08/21 2209 | Final result | Specimen: Swab from Nasopharynx COVID-19 Overall Result External DetectedCritical
CDC Split Type:

Write-up: Vomiting ED Discharged 8/4/2021 (3 hours) Hospital ED Clinical impression Diarrhea ? Vomiting , Vomiting and diarrhea Dehydration AKI (acute kidney injury) Admission 8/8/2021 Source Organization Discharge Summary Patient - 66 y.o. Female; Discharge Summary, generated on Aug. 11, 2021 Weakness - Generalized Encounter Details Date Type Department Care Team Description 08/08/2021 - 08/11/2021 Hospital Encounter Hypoxia (Primary Dx); COVID-19; Hypokalemia; Acute respiratory failure with hypoxia; Hypomagnesemia; Hypocalcemia; Weakness


VAERS ID: 1582397 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-07-31
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A27A / 1 LA / -

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

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

Write-up: tingling, rash developed into shingles


VAERS ID: 1582430 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-24
Onset:2021-07-31
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Dehydration, Diarrhoea, Haemoconcentration, Haemoglobin decreased, Nausea, Pyrexia, Respiratory symptom, SARS-CoV-2 test positive, Throat irritation, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: The patient is a 67-year-old male with diabetes, hypertension, prostate CA, who presented to the hospital with vomiting, diarrhea, weakness, recent Covid diagnosis. The patient completed his COVID-19 vaccination in April 2021. 15 days ago or so, his son started to have symptoms with fever, respiratory symptoms. He ended up positive for Covid. Patient himself has about 1-1/2-week history now of symptoms. He tested positive at a CVA 10 days ago. Started with a fever, then developed scratchy throat and cough. For the past few days he has been nauseated, with multiple episodes of nonbloody emesis. the patient''s hospital course was uneventful. He has not required supplemental O2 therefore there was no clinical need for steroid injections. He was treated supportively with IV fluids. He was quite dehydrated as he was hemoconcentrated with his hemoglobin initially at 15 and now it is 12. He has not had recurrent diarrhea. His generalized weakness overall is improved, overall feeling better.


VAERS ID: 1582754 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-08
Onset:2021-07-31
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 5 mg tablet aspirin 81 mg tablet benazepriL (LOTENSIN) 40 mg tablet fexofenadine (ALLEGRA) 180 mg tablet sertraline (ZOLOFT) 100 mg tablet
Current Illness:
Preexisting Conditions: Respiratory CPAP (continuous positive airway pressure) dependence OSA on CPAP Circulatory Hypertension Sinus tachycardia Cardiomegaly Internal hemorrhoids Right ventricular dilation Digestive Diverticulosis Calculus of gallbladder Class 3 severe obesity in adult (CMS/HCC) Musculoskeletal Enthesopathy Endocrine/Metabolic Impaired fasting glucose Hematologic Leukocytosis Other Depression Generalized anxiety disorder Malignant neoplasm of upper-outer quadrant of left breast in female, estrogen receptor positive (CMS/HCC) Panic disorder without agoraphobia Hx of pulmonary embolus
Allergies: PenicillinsAnaphylaxis
Diagnostic Lab Data: 08/03/21 1650 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/02/21 1757 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/03/21 1650 COVID-19 PCR Collected: 08/02/21 1757 | Final result
CDC Split Type:

Write-up: Exposure to COVID-19 virus. Internal Medicine COVID-19 virus infection. Dx: Medication Infusion. Reason for Visit Progress Notes, Internal Medicine, Encounter Date: 8/5/2021, Patient is here for MAB Infusion O2 sats $g or = 90%. Signs of potential reaction reviewed with patient. Tolerated IV start and MAB infusion without complication. Patient has access to pulse oximeter and thermometer for home monitoring. Discharge instructions reviewed. Patient denies any questions.


VAERS ID: 1582946 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-10
Onset:2021-07-31
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA RA1563 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Malaise, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills; Synthroid; Advair; Zytec; Bybane
Current Illness: nothing
Preexisting Conditions: I have asthma.
Allergies: not that I know of
Diagnostic Lab Data: COVID test which was positive on the 2 on July 29th and July 31st that were negative/ then one on August 2nd which was positive.
CDC Split Type: vsafe

Write-up: I was exposed to COVID from someone who was vaccinated. I was sick with body aches, difficulty breathing, coughing, fatigue, fever. I did the nebulizer every 4 hours and increased my Advair dosage to a higher dose. I took Tylenol.


VAERS ID: 1583369 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-26
Onset:2021-07-31
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Antibody test, Arthralgia, Blood folate, C-reactive protein, Condition aggravated, Crohn's disease, Full blood count, Haemorrhage, Muscle spasms, Stool analysis, Vitamin D
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal premalignant disorders (narrow), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Arthritis (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humira, mesalamine
Current Illness:
Preexisting Conditions: Crohn?s
Allergies:
Diagnostic Lab Data: Pending stool sample, CBC, CRP, folate, vitamin D, humira antibody level to be sent 8/19-8/23
CDC Split Type:

Write-up: 4 days after began to have crohns flare (cramping, bleeding,bloating, etc) as well as joint pain


VAERS ID: 1583370 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 3 LA / IM

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

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

Write-up: He requested and got the shot earlier than it was approved. No issues with the injection.


VAERS ID: 1586661 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-10
Onset:2021-07-31
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, No adverse event, Pyrexia, SARS-CoV-2 test positive, Sinusitis, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 125mcg Imbruvica 140mg
Current Illness:
Preexisting Conditions: Hashimoto''s Thyroiditis Chronic Lymphocyctic Leukemia
Allergies: Penicillin
Diagnostic Lab Data: 7/31/2021 woke up with what felt like a bad sinus infection, cough and a fever of 100.4. Went to a local MD Now, got tested for Covid 19 and the results came back positive.
CDC Split Type:

Write-up: I did not have an adverse reaction to the vaccine, I am just trying to report a break through covid 19 infection. Because I have CLL and was taking Imbruvica, I had heard it may have affected the vaccine''s efficacy, so I joined a study with the Leukemia and Lymphoma society and found I only go 19 antibodies. While apparently not enough to stop the infection, I never got so bad the I felt I required hospitalization.


VAERS ID: 1586822 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Injection site rash, Injection site swelling, Pain, Pyrexia, Rash, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocodone/Acetaminophen - 5-325 TB: 1 tablet PO q6 hrs. PRN (moderate-severe pain). Skelaxin (Metaxalone) - 800mg: 1 tablet PO q12 hrs. PRN(muscle spasms, muscle pain). Tramadol (Ultram) ? 50 mg: 1 tablet PO q8 hrs. PRN (mild to moderate
Current Illness: Atrial Fibrillation (cardiac ablation on 8/27/21); Chronic cough (being treated with medication)
Preexisting Conditions: GERD; Fibromyalgia; Hypothyroid; Hypertension; Bilateral Cataracts; Rosacea; Hyperhidrosis; POTS; Autonomic Dysfunction; Alopecia; chronic vertigo; High Cholesterol; Sleep Apnea.
Allergies: Codeine, Zoloft, Procardia, Isosorbide.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Developed a fever of 101.4 F, pain and some swelling at injection site, chills, full body pain, dizziness, hive/rash around site and fatigue started during evening of vaccine. Slept throughout weekend. The rash continued to spread on extremities in a scattered pattern and became extremely itchy. Used Benadryl oral and cream. Knew some adverse effects occur, thought they''d go away. Rash & itching continued. Went to Urgent Care on 8/5/2021, by then just looked like a scattered rash over extremities and trunk (esp. buttocks, midsection). Given Methylprednisolone 4mg Dose Pak 21S & Triamcinolone Acetonide Cream 0.5%. Rash improved but not gone and still very itchy but not as bad. Following up with primary doctor on 8/20/2021.


VAERS ID: 1588558 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Medication errors (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: KNDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received 2nd Covid Pfizer vaccine 14 days from the 1st vaccine. Father says patient had rash on waist/hip that resolved in around 7 days


VAERS ID: 1591762 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: since July 31st i have been taking Benedryl OTC creams for itching, Zyrtec soaking in oatmeal epsom salt baths to try and help itching go away. seem to be getting more intense of the 3 week as of today. in the last week i have also noticed
Current Illness: seasonal allergies that i always have.
Preexisting Conditions:
Allergies: the only allergy that i have is to Sulfur that i am aware at this time.
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe itching all over the body and getting more intense as time goes by. Doctors office advised to delay 2nd dose and will see an allergist soon.


VAERS ID: 1591965 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Seizure
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: depo-testosterone, trazodone, cymbalta, ativan, flomax, sildenafil
Current Illness:
Preexisting Conditions:
Allergies: acetaminophen, cimetidine, griseofulvin
Diagnostic Lab Data:
CDC Split Type:

Write-up: convulsions lasting for a half hour, starting at 6 AM the day after vaccination. Per patient, venous distention in entire body.


VAERS ID: 1592020 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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: .88 mcg levothyroxine
Current Illness: None
Preexisting Conditions: None
Allergies: Cilantro allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: A numbness occurred in the left arm and through the left side of the body on day 1-3. Medical attention was sought and it was determined that no signs of stroke were present. Numbness and pain continued and medical treatment was sought again on August 14, 2021. That examination didn?t find any cause to the pain and numbness but suggested pain reliever and icing/massaging the injection site. The numbness continues with no other direction on treatment.


VAERS ID: 1592068 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-21
Onset:2021-07-31
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Constipation, Full blood count normal, Lipase normal, Pregnancy test urine negative, Thyroid function test normal, Urine analysis normal, X-ray gastrointestinal tract abnormal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: no
Preexisting Conditions: she has sinus issues
Allergies: No just beestings
Diagnostic Lab Data: 2 Xrays on her abdomen and they found severe constipation. urinalysis and she isn''t pregnant and no uti. CBC, lipase, thyroid bloodwork and all came back normal. Tuesday they will do the ultrasound scan of her gallbladder. Last night they did murphy''s sign test and she was positive for pain around her gallbladder.
CDC Split Type: vsafe

Write-up: So far she started having severe abdominal pain and we went to the doctor and they did an x-ray and they said she had severe constipation. And after he got her colon emptied she was still having pain so he referred her to an OBYN to see if there is a cyst on her ovary. We went to the ER last night because her pain was where she couldn''t handle it anymore and they doctor they will do an ultrasound scan of her gallbladder because they think it could be inflamed. Her murphy''s sign test came out positive.


VAERS ID: 1593914 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PVIUS2021001162

Write-up: Joint pain in left arm/arm joint pain; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (Joint pain in left arm/arm joint pain) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 31-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jul-2021, the patient experienced ARTHRALGIA (Joint pain in left arm/arm joint pain). At the time of the report, ARTHRALGIA (Joint pain in left arm/arm joint pain) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.


VAERS ID: 1595938 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-24
Onset:2021-07-31
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 1 RA / IM

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

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Additional Details: patient has hives that started 1 week after vaccine and has not resolved. patient has taken allergy antihistamines


VAERS ID: 1602588 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: patient received three pfizer vaccines as per system 4/19/2021 5/10/2021 7/31/2021 no reactions reported


VAERS ID: 1602640 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-12
Onset:2021-07-31
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0428A21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Arthralgia, COVID-19, Cough, Fatigue, Infusion, Myalgia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: alopurinol; Xarelto; Crestor; Niaspan; losartan; Toprol; Biotin; Vitamin C; keratin; Zinc
Current Illness: I did not have any illness at the time of vaccination.
Preexisting Conditions: heart disease; arthritis; A-Fib; Gout; skin cancer.
Allergies: I do not have any allergies.
Diagnostic Lab Data: I had a COVID-19 test completed and it was positive.
CDC Split Type: vsafe

Write-up: Three weeks ago, I was diagnosed with COVID-19. I was experiencing a fever over 101, aching joints and muscles, coughing, fatigue and eventually lost my sense of taste and smell. I received an infusion a few days after testing positive. As of today, I am still coughing.


VAERS ID: 1602903 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (broad)

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

Write-up: A few hours after receiving my first COVID vaccine I began experience joint pain. My left knee became the worst and I couldn?t even bend it. It subsided by the next day. When I told the pharmacy, they told me that people don?t experience that after the first vaccine. I told them that?s what I experienced and they told me no I didn?t. So I came here to report it. I just got my second vaccine today. So hopefully it?s not as bad.


VAERS ID: 1609856 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Wrong patient
SMQs:, Medication errors (narrow)

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

Write-up: Error: Wrong Patient (documentation in EMR)-


VAERS ID: 1609859 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Wrong patient
SMQs:, Medication errors (narrow)

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

Write-up: Error: Wrong Patient (documentation in EMR)-


VAERS ID: 1617710 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chills, Disorientation, Pruritus, Pyrexia, Rash, Skin swelling, Syncope, Urticaria, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram, Viorelle, Myo-Inositol & D-Chiro Inositol Blend
Current Illness: N/A
Preexisting Conditions: Polycystic Ovary Syndrome
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Exactly 24 hours after receiving the vaccine, I began to develop a rash that turned into hives that were all over my body. My skin had a swollen appearance and became both itchy and burning. Within an hour after this rash started I fainted, immediately got back up, and faint right after. I was out for 2 minutes on the second faint. I vomited nearly 5 times an extreme amount. I had a fever, chills, and was disoriented. My blood O2 levels were in the 30''s the entire time and my heart rate stayed between 95-110. All of these symptoms lasted from around 5:00 pm to 9:30 pm I took anti histamine immediately after the rash start and still have the symptoms above.


VAERS ID: 1623412 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Dyspnoea, Joint swelling, Pollakiuria, Pruritus, Rash, Sticky skin
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: none
Preexisting Conditions: Hypertension and HIV positive (Under detected)
Allergies: flagyl
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash all over my body but on my hands, face and neck was the worst. the rash and bumps and burn. The rash and the dumps were very itch and were like in round circle on my body. I experienced frequently going to the restroom started on JULY 30. I was going to the restroom every 10-20 minutes urinating that ended on Sunday. I did not take any hypertension medication before my shot or after. my skin felt very itch on the inside were and sticky. i also had swallowing of my joint and shortness of breathe.


VAERS ID: 1623464 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Factor 5
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pains on left side- Steady for 15 days Shoulder pains on left side - Steady for 15 days Severe Chest Pain in the middle of the night 10 days after the second dose.


VAERS ID: 1623482 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-25
Onset:2021-07-31
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cyst
SMQs:

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

Write-up: He got a cyst formed on the inside ankle of his right leg. I noticed it a few days after the 1st shot. We were not sure if it was related to the COVID vaccination. He had the second shot on 08/15/2021 at the same clinic. The lot # for the second shot is EW0191. I noticed the cyst became bigger a few days after the second shot. It got smaller at the time of submitting this report.


VAERS ID: 1624843 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Lip swelling, Oral disorder, Oropharyngeal pain, Skin erosion, Stomatitis, Swollen tongue
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Right side of tongue swelled, sore throat, ear pain then when those symptoms began to subside there were oral lesions, lips swelled, mouth sores and corners of the mouth felt raw


VAERS ID: 1625282 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-31
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Nausea
SMQs:, Acute pancreatitis (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin latex
Diagnostic Lab Data: Ekg, blood sugar, blood pressure
CDC Split Type:

Write-up: 1 day later I expirenced dizziness and nausea. 3 days I was weak and very dizzy with nausea. I went to the dr 2 weeks later and I was prescribed motion sickness pills and pills for nausea. It''s been 3 weeks and I still feel like this


VAERS ID: 1627736 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test normal, Dizziness, Fatigue, Laboratory test normal
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: Systemic: Weakness-Medium, Additional Details: 1 day after 1st shot, patient extreme fatigue/weakness & felt like passing out while cutting grass. He had to take frequent breaks in order to complete that task which was abnormal for patient. 3 days later, he noticed a 150 lb difference in the weight that he could lift. He saw MD (okayed 2nd shot) who stated that there''s nothing wrong & all labwork/bloodwork came back normal. MD & I aren''t sure of cause but patient states nothing else in his life changed including medications & stress level.


VAERS ID: 1628007 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

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

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

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


VAERS ID: 1628011 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Angiopathy, Aphasia, Blood pressure increased, Borrelia test negative, C-reactive protein normal, Cryptococcus test, Cytology normal, Ear pain, Ehrlichia test, Epstein-Barr virus test negative, Eye pain, Feeling abnormal, Herpes simplex test negative, Inflammation, Joint stiffness, Liver function test increased, Lumbar puncture abnormal, Lymphocyte count increased, Magnetic resonance imaging head abnormal, Memory impairment, Meningeal neoplasm, Migraine, Musculoskeletal stiffness, Neoplasm malignant, Red blood cell sedimentation rate normal, SARS-CoV-2 test negative, Scan with contrast abnormal, Scintillating scotoma, Tenderness
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Retinal disorders (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow), Non-haematological tumours of unspecified malignancy (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid , losarten, rosuvustatin, fluoxetine, tylenol
Current Illness:
Preexisting Conditions: Cutaneous T cell lymphoma Hx Hashimotos s/p ablation Vitiligo localized Hypertension High cholesterol controlled w statin Hx ITP age 5 perhaps after viral infection 1968 ? Hong Kong Flu
Allergies: Alpha gal mammalian meat allergy beef pork lamb etc
Diagnostic Lab Data: LUmbar puncture x 2: normal pressure, increased lymphocytes no abnormal markers, cytology normal. Infectious markers were checked, Lyme, cryptococcus, ehrlichia, numerous all negative as was Covid, ebv, HSV1 & 2, etc. ESR and CRP neg. LFTs mild increase. Peripheral blood lymphocytes increased. Reviewer would need to see extensive labs ordered.
CDC Split Type:

Write-up: At 48 h developed migraine which became continuous and hard to control w NSAIDS , baby ASA. Elevated BP to 170s/ 85 previously controlled to 135/70. At times migraine associated w scintillating Scotomas. Behind eye ache, slight ear pain. In distribution of left temporal artery. Artery tender to touch. Severe brain fog. Some word searching, memory change.Left finger joint stiffness. Continued x 2 weeks went to urgent care. Uncertain dx. Treated w NSAIDS, rxd prednisone 20mg but only took one dose. Aug 16 had follow up w oncologist routine. Mentioned new migraines got MRI brain contrast showed L parietooccipital meninges lighting up. Diff dx: cancer, inflammation, vascular is. Admitted to hospital same day fir work up.


VAERS ID: 1629523 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Impaired work ability, Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (broad)

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

Write-up: Severe flare ups in joints are 24 hours of second dose causing me to not be able to work


VAERS ID: 1632014 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Sexual dysfunction (broad)

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

Write-up: Site: Pain at Injection Site-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Patient described "paralysis" in immunization arm. Was very hesitant to receive vaccine. Administering pharmacist discussed risk/benefit of vaccination with patient. Patient stated her doctors wanted her to get it, but wasn''t sure. Pharmacist stated she didn''t have to get shot if she was concerned, but patient decided to proceed. Before the needle punctured skin, patient yelped in pain and pulled away, and did the same after administration. Did not notify pharmacy of issue until day of 2nd dose.


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