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From the 5/7/2021 release of VAERS data:

Found 188,897 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 32 out of 1,889

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VAERS ID: 1213466 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-04-15
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: pain in lower leg, slight swelling


VAERS ID: 1214279 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-01
Onset:2021-04-15
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Influenza like illness, Neck pain
SMQs:, Arthritis (broad)

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

Write-up: Patient''s daughter called on her behalf to translate from Spanish. She reported that her mother was having "flu-like" symptoms approximately 3 weeks after receiving the J&J vaccine. She also mentioned that she was having a headache in the back of her head and neck which are known to be possible indication of a cerebral venous sinus thrombosis which has been rarely associated with the J&J vaccine. I advised the daughter to take the mother to the emergency department for further evaluation and she agreed that she would take her right away.


VAERS ID: 1214402 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Decreased appetite, Fatigue, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fatigue, weakness, malaise, n/v, joint pain, chills, diarrhea, anorexia. Treated with ondansetron and NS 1L.


VAERS ID: 1214552 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram normal, Fatigue, Metabolic function test, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None, patient healthy at the time of vaccination and up to one month prior
Preexisting Conditions: None
Allergies: Aspirin, reaction: hives
Diagnostic Lab Data: 4/15/21 08:48 AM: EKG showed sinus rhythm, with ventricular and atrial rates of 100 beats per minute, QTc (Bezet) of 448. 4/15/21 09:48 AM: repeat EKG showed normal sinus rhythm with sinus arrhythmia, ventericular and atrial rate of 87 beats per minute. QTc (Bezet) of 428. 4/15/21 10:23 Basic Metabolic Panel (BMP) showed no abnormalities
CDC Split Type:

Write-up: Patient developed dizziness and lightheaded 15 minutes after the vaccine. Then felt fatigued the next day. Patient is an avid runner who runs three to four times week. Today (4/15/21), patient developed tachycardia in the high 180s ten minutes into her run. She then stopped running and started walking on flat surface for 30 minutes in hopes to slow down her heart rate. However, after 30 minutes of walking her heart rate remained in the 185 to 205 beats per minutes. The tachycardia lasted for one hour since she stopped running. She then came to the ED for check ups.


VAERS ID: 1214558 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Headache
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad)

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

Write-up: Received vaccine on 4/11. 4/15 developed headache, low back pain/bilateral hip pain, very painful. She has been relieving symptoms by stretching and using a heating pad


VAERS ID: 1214603 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-04-15
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: COVID-19 Vaccine Breakthrough Case


VAERS ID: 1214654 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-02
Onset:2021-04-15
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray abnormal, Diarrhoea, Fibrin D dimer increased, Hypoxia
SMQs:, Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASPIRIN ; ATORVASTATIN ; VIACTIV ; VITAMIN D ; LEVOTHYROXINE ; LISINOPRIL ; MECLIZINE ; OMEGA 3 FISH OIL ; PANTOPRAZOLE
Current Illness: DIARRHEA, HEMATURIA, WEAKNESS
Preexisting Conditions: HYPERLIPEMIA , OSTEOPENIA, HYPOTHYROIDISM, GI REFLUX DISEASE, PULOMNARY NODULE, VITAMIN D DEFICIENCY
Allergies: ALENDRONATE - GI DISTRESS OMEPRAZOLE - ANAPHALYXIS/ANGIOEDEMA, THROAT CLOSED SULFONAMIDE ANTIBIOTIC - NEUROLOGIC REACTION
Diagnostic Lab Data: D DIMER - 1.78 MG/L FEU BILATERAL PVL EXAM CHEST XRAY - POSSIBLE PE INVOLVING LLL
CDC Split Type:

Write-up: PATIENT PRESENTED TO ER WITH COMPLAINT OF DIARRHEA SIN AM OF 4/14/21. ER WORKUP WAS UNREMARKABLE EXCEPT PT WAS HYPOXIC. HOSPATILIST CONSULTED AND PATIENT WAS ADMITTED FOR OBSERVATION DUE TO HYPOXIA


VAERS ID: 1214710 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-13
Onset:2021-04-15
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Headache, Neck pain, Neuralgia, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (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: Propranolol, levothyroxine, multivitamin, vitamin D3
Current Illness: None
Preexisting Conditions: Subluxation of C3 an C4 of neck, low back pain
Allergies: Bees, shrimp, biaxen, compazine, hydrocodone, IVP conteast
Diagnostic Lab Data: None on 3-19-21. Just checked pulse in swollen arm
CDC Split Type:

Write-up: Headache. Severe , burning, nerve pain in neck shoulders and both arms . Right arm swollen from elbow to wrists. Went to Dr. on 3-19-21 . Told to return in 3 days if not better. They said pulse was ok so prob not a clot. I had pain for two weeks but did not return. At end of two weeks swelling gone . Still some residual pain in right arm, but not constant.


VAERS ID: 1214750 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-12
Onset:2021-04-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Zinc, Fexodenadine 180mg
Current Illness:
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chills 8 hours after injection. Fever of 102, body aches, 8-16 hours after. Fever of 100, body aches, nausea, fatigue 16-30 hours after injection.


VAERS ID: 1214779 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-15
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 5 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: PCN, Latex-- $g Rash
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: She Had bumps and Rash all over body especially on her Torso and arms. She said it was itching all over


VAERS ID: 1214825 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-01
Onset:2021-04-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1085029 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Loss of personal independence in daily activities, Sleep disorder
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, metformin, vitamin d, magnesium,prenatal, b12
Current Illness: Recovery from labor&birth 3/13. Mastitis antibiotics during time of vaccine, started 3/23
Preexisting Conditions: PCOS
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness at shot site for 3 days. Soreness progressed further down upper arm into muscle pain that has been persistent for two weeks. Not getting better. Affecting ability to carry things and keeping me up at night w the pain. Center of upper arm.


VAERS ID: 1215131 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Night sweats, Pain, Pyrexia, Visual impairment, Vitreous floaters
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shots- always get flu symptoms for many days after
Other Medications: tumeric, oregano oil, wellness formula
Current Illness: na
Preexisting Conditions: toxoplasmosis
Allergies: na
Diagnostic Lab Data: n/a did not go to the doctor/hospital for the adverse events
CDC Split Type:

Write-up: That evening , started getting feverish and had temperature fluctuations, night sweats, body was sore all over. Then the next day notied that my eyesite in my left eye seemed off- noted I had floaters and could not see as well as previously. I assume this is a flare up of Toxoplasmosis as the eye symptoms are the same.


VAERS ID: 1215547 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-01
Onset:2021-04-15
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK LA / SYR

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

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: Na
Current Illness: I don''t have any side effects after taking J&J vaccine. No sore arm either.
Preexisting Conditions: Na
Allergies: Na
Diagnostic Lab Data: Na
CDC Split Type: 1802072

Write-up: N/a


VAERS ID: 1215840 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Arteriogram carotid abnormal, Cerebrovascular accident, Computerised tomogram head, Computerised tomogram neck, Interventional procedure, Thrombolysis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: entresto
Current Illness:
Preexisting Conditions: a fib; heart disease; chf
Allergies: no
Diagnostic Lab Data: CTA head and neck
CDC Split Type:

Write-up: large MCA stroke, thrombolytics and interventional clot extraction


VAERS ID: 1215875 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperhidrosis, Rash, Sensitive skin
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Rash around groin, sensitive hands and feet, waking up around 4am sweating.


VAERS ID: 1215916 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Pt. had minor abdominal pain. No treatment necessary at this time


VAERS ID: 1215945 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Fibrin D dimer increased, Pulmonary embolism
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: metoprolol, Norvasc, metformin, atorvastatin
Current Illness: none
Preexisting Conditions: DM, HTN, BPH, HLD
Allergies: nkda
Diagnostic Lab Data: Elevated D Dimer 4/15/2021 Chest CT/PE protocol 4/15/2021
CDC Split Type:

Write-up: Bilateral Pulmonary Emboli


VAERS ID: 1216127 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril ESCITALOPRAM
Current Illness: No
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Hive like rash located on wrist hands feet and stomach. Took benadryl


VAERS ID: 1216218 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Anaphylactic shock, Dyspnoea, Hypoaesthesia, Pharyngeal swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Amphylactic shock Numb arm Breathing Throat swelling


VAERS ID: 1216225 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-13
Onset:2021-04-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Headache, 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: N/A
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: ROS: (10+) CONSTITUTIONAL: subjective fever, subjective chills, no night sweats EYES: No blurry vision, no loss of vision, no black spots, no curtain of lights. EAR, NOSE, THROAT
CDC Split Type:

Write-up: Fever, HA and body aches x 2 days after receiving J&J vaccine on 13 Apr 21. Pt report taking tylenol and ibuprofen with minimal relief; last dose meds yesterday at 1800.


VAERS ID: 1216267 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 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? No
Previous Vaccinations:
Other Medications: Bystolic 5mg 1xdaily Synthroid 125mcg 1xdaily Duloxetine 60mg 1xdaily Divalproex 250mg 1xdaily D3 250mcg 1xweek Armodafinil 150mg As Needed
Current Illness: None
Preexisting Conditions: Depression Hashimotos Thyroiditis
Allergies: IVP dye Pennicilin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: None at time of injection


VAERS ID: 1216327 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bystolic 5mg 1xdaily Synthroid 125 mcg 1xdaily Duloxetine 6pmg 1xdaily Divalproex 250mg 1xdaily D3 250mcg 1xdaily Armodafinil 150mg As Needed
Current Illness: Depression Hashimoto''s Thyroiditis
Preexisting Conditions: Depression Hashimoto''s Thyroiditis
Allergies: IVP Dye=Asystole Pennicilin=Hives
Diagnostic Lab Data: None performed to date
CDC Split Type:

Write-up: 04/09/2021 - None at time of injection. 04/15/2021 - Left leg pain, left foot swelling, left foot tingling.


VAERS ID: 1216602 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Nausea, Oral discomfort, Tongue pruritus
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, insulin
Current Illness:
Preexisting Conditions: Type 1 diabetes, iron deficiency
Allergies: Macrobid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt experienced burning sensation inside mouth, itchy tongue, and nausea. Pt has had similar reaction in the past when given macrobid, which pt is allergic to. Pt did eat 45 minutes before appt and has stated that they have type 1 diabetes.


VAERS ID: 1216616 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Feeling hot, Pallor, Paraesthesia, Presyncope, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: About 5 minutes after receiving the shot, patient complained of being light headed, hot, patchy vision, loss of hearing, pale color and almost passed out at the pharmacy contour. He had been helped to have a seat and drink some water, about 5 minutes later he felt much better but only experienced tingling in his fingertips. He stayed for another 20 minutes in pharmacy and mentioned he felt totally alright before leaving the pharmacy area.


VAERS ID: 1216620 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Headache, Muscle fatigue, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: N/A.
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin.
Diagnostic Lab Data: N/A.
CDC Split Type:

Write-up: Muscle fatigue, headache, and drowsiness.


VAERS ID: 1216629 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO162 / 2 RA / SYR

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

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: Insulin, Jardiance, Statin,
Current Illness: None
Preexisting Conditions: Diabetes T2
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Post eating blood sugar normally runs 200-220. Today after receiving the 2nd dose, post 2 hour blood sugar ( without taking insulin x24 hrs ) was 340. I take 30 units of Humalog after eating. And 100 units of Lantus at night.


VAERS ID: 1216633 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Paraesthesia oral, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE MENTIONED
Current Illness: NONE MENTIONED
Preexisting Conditions: NONE MENTIONED
Allergies: NONE MENTIONED
Diagnostic Lab Data: BP 89/55 HR 61
CDC Split Type:

Write-up: PATIENT COMPLAINED OF DIZZINESS AND BLURRED VISION AFTER 5 MINUTES OF RECIEVING THE VACCINE. AFTER PHARMACIST CONSULTATION, IT WAS DETERMINED THAT THE PATIENT HAS A PREVIOUS HISTORY OF FAINTING WITH NEEDLES UPON BLOODWORK BUT NOT COMMONLY WITH VACCINES. THE PATIENT ALSO RELAYED TO THE PHARMACIST THAT SHE DID NOT EAT ANYTHING SINCE THE MORNING AND ALL SHE HAD TO EAT IN THE MORNING WAS A BANANA. WE GAVE HER WATER AND MOVED HER TO A ROOM IN WHICH SHE WAS ABLE TO REMOVE HER MASK AND BREATHE EASIER. SHE THEN REPORTED OF TINGLING IN HER UPPER LIP. SHE WAS GIVEN A SNACK TO ASSIST WITH SYMPTOMS OF POSSIBLY HYPOGLYCEMIA. WE MONITORED HER FOR ANOTHER 15 MINUTES CONTINUOUSLY CHECKING ON HER AND HER SYMPTOMS ALL STARTED IMPROVING AND RESIDING. AFTER 30 MINUTES OF CLOSE MONITORING THE PATIENT FELT WELL ENOUGH TO GO HOME.


VAERS ID: 1216641 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 10mg Escitalopram per day 2 Capsules of Immune Defense by Dakota Nutrition per day 900mg capsule of Krill Oil Per Day 400mg capsule of NatureMade Magnesium per day
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swollen lymph nodes in armpit-same arm shot was given-left arm


VAERS ID: 1216643 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / IM

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

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

Write-up: Patient fainted about 5 minutes after receiving vaccine. Pharmacist checked patient and she had a pulse. Patient quickly gained conscious and laid down on the floor. Patient said she usually faints when she receives a vaccine or has her blood drawn. Pharmacist checked patient''s blood pressure and pulse, within normal range.


VAERS ID: 1216644 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Dysarthria, Loss of consciousness, Peripheral coldness
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pt c/o of light headedness while in observation. Pt had slurred speech, skin was cold and clammy, and pt had intermittent loss of consciousness. Maintained pt in a comfortable position until EMS arrived. BP 193/130, HR 124, O2 99%, RR 14.


VAERS ID: 1216645 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B27A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Injection site rash, Lymphadenopathy
SMQs:, 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: Daily multivitamin Occasional Claritin
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash at injection site (3x3 inches) Swollen armpit lymph node on left side Both occurring the morning of 4/15


VAERS ID: 1216647 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-13
Onset:2021-04-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone (For acne)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Low fever (100.2), body aches, tiredness


VAERS ID: 1216649 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-13
Onset:2021-04-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast swelling, Breast tenderness
SMQs:, Angioedema (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: Obesity
Allergies: Erythromycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling and tenderness in breast tissue under armpit (possibly lymph nodes)


VAERS ID: 1216654 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Flatulence, Immediate post-injection reaction, Injection site bruising, Injection site induration, Injection site inflammation, Injection site pain, Injection site pruritus, Injection site rash, Injection site warmth, Lymphadenopathy, Pain, Pain in extremity, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins (to support my nursing child), vitamins C, D, zinc, DoTerra OnGuard essential oil to support immune system. Ibuprofen for discomfort after vaccine.
Current Illness: None.
Preexisting Conditions: None.
Allergies: I have sensitive skin and have strong reactions to bug bites and sometimes react to skin trauma.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Day 1-3 had painful and sore arm near injection site. (It felt like the vaccine settled in my arm about an inch below the injection site. It seemed slightly inflamed and was sore to the touch). Bruise developed at injection site (possibly due to needle bursting blood vessel) which is still present 7 days after vaccination was administered. One week after vaccination a rash developed on my left arm in the same area that was painful immediately after the injection of the Moderna vaccine. Rash is red, firm, slightly inflamed/raised, warm to the touch, and itches. I have been treating with topical ointments (benadryl cream, cortisone cream) and ice packs applied to the area. Other symptoms that manifested the same day the rash began: gas, lose stool, fatigue, body aches, swollen lymph nodes in throat.


VAERS ID: 1216659 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

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

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

Write-up: Clear liquid draining


VAERS ID: 1216666 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysgeusia, Ear congestion, Gaze palsy, Loss of consciousness, Paraesthesia oral, Pyrexia, Skin warm
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: The patient reported a metallic taste and pressure behind her ears at 6:52pm, about 2 minutes after the Moderna vaccine was administered. She then reported feeling lightheaded and tingling in her lips. I assisted her to the floor and had her lay down. She reported feeling feverish and she was warm to the touch, but her temperature was 98.4 degrees Fahrenheit. Her O2 was at 99%. She briefly lost consciousness around 6:55pm as evidenced by her not responding to my questions or to me roughly shaking her arm. She regained consciousness within a couple seconds. Patient then reported a sudden headache at 6:57pm. EMS arrived at 7:01pm. The patient left with EMS.


VAERS ID: 1216667 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

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

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

Write-up: Swelling and puffiness at the injection site, itchiness, and heat.


VAERS ID: 1216674 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Duloxetine, riboflavin, magnesium
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbness and warm tingling sensation in upper arm. Persisted for several hours. Began almost immediately after injection and travelled from injection site to near the elbow. Slowly dissipated after serval hours.


VAERS ID: 1216681 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site bruising, Injection site pain, Injection site swelling, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine 60 mg Metoprolol 100 mg Losartan 50 mg Zaleplon 10 mg Aspirin 81 mg Tylenol 200 mg
Current Illness:
Preexisting Conditions: Depression HBP Heart attack 12/2018
Allergies: Penicillin Codine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pronounced swelling in arm at injection site 8 days after receiving the vaccine. Looks slightly bruised, bluish color. Sore to touch. Sore to move arm.


VAERS ID: 1216686 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia, Vital signs measurement
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: Metformin
Current Illness: unknown
Preexisting Conditions: Diabetes
Allergies: Denies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client had 2nd dose of COVID vaccine, ten minutes later reported her fingers felt tingly. Vital signs stable, denies any other symptom. "Tingling sensation" resolved 15 minutes later, client able to go home.


VAERS ID: 1216690 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling, Rash, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Adderall , vitamin D, daily multi vitamin
Current Illness: None
Preexisting Conditions:
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Development of arm rash which is warm to the touch swollen and painful


VAERS ID: 1216700 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-04-12
Onset:2021-04-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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

Write-up: Bell''s palsy


VAERS ID: 1216701 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA COVID-19 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin B-12,, vitamin C, vitamin E, CoQ10, Alpha-Lipoic Acid, and Doxycycline Monohydrate
Current Illness: n/a
Preexisting Conditions: breast cancer (stem cell) 24 years ago
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: red around injection site, itchy, swollen, tender/sore


VAERS ID: 1216703 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Hypertension, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (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: Severe headaches and higher BPM. body aches and fever.


VAERS ID: 1216706 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-12
Onset:2021-04-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Hives over entire back


VAERS ID: 1216707 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Groin pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Osteonecrosis (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, effexor, iron, b12, multivitamin, metformin
Current Illness: Cold 3 weeks ago
Preexisting Conditions: VSD, diabetes
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 15 min after, when standing up, had medium pain in my left groin area between groin and leg. Then around 930pm became extremely itch, starting with left leg. Moved to all over body by 1030 pm


VAERS ID: 1216708 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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: Headache


VAERS ID: 1216720 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysgeusia, Pruritus
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: After receiving first COVID vaccine patient reported tasting metal, itchiness in right leg. Patient was monitored for an additional 10 minutes, no additional symptoms were noted during while being monitored.


VAERS ID: 1216759 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 RA / IM

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

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

Write-up: Rash over/around injection site. Raised, red and itchy. Applied hydrocortisone to help provide relief to itchy. Temporary relief achieved.


VAERS ID: 1216765 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 - / SYR

Administered by: School       Purchased by: ?
Symptoms: Bone pain, Chills, Cough, Fatigue, Feeling abnormal, Headache, Hot flush, Myalgia, Nausea, Temperature regulation disorder, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolog insulin quick pen, vitamin d +k supplement, probiotic supplement
Current Illness:
Preexisting Conditions: Type 1 diabetes
Allergies: C-Chlor (medication) Bee stings
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore vaccination site, started to get brain fog which lead to a headache, fatigue, extreme urge to cough, aches muscles, inability to regulate temperature (back and forth chills and hot waves), nausea, and sharp pains in my bones. Treatment: drinking water Started around 3 and has gotten progressively worse


VAERS ID: 1216772 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Ear pain, Pharyngeal swelling, Pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), 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)

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

Write-up: Patient received first Pfizer COVID vaccine with subsequent shortness of breath, subjective throat swelling and ear pain/itching. Patient was taken to the ED for ongoing evaluation and is taking 50 mg of Benadryl, IV fluids, 125 mg of methylprednisone, and 20 mg famotidine followed by reevaluation. Patient had no additional symptoms and discharged.


VAERS ID: 1216782 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-05
Onset:2021-04-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Covid arm, or vaccine arm. A large lesion of redness appeared on my left arm (where I got the shot) around 10 days after I received my first dose of Moderna vaccine. The rash is itchy and it looks very big. It is a little swelling, too.


VAERS ID: 1216784 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / SYR

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

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

Write-up: Swollen at injection cite, painful at touch, itchy, and hard at touch It is about four inches big, circular shape Only taken acetaminophen for arm pain


VAERS ID: 1216904 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Discomfort, Eye irritation, Eye pain, Feeling cold, Headache, Ocular hyperaemia, Pain, Piloerection, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Corneal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propranolol 80mg bid, zyrtec 10mg, flonase
Current Illness: None
Preexisting Conditions: Hypertension, obesity
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 7pm started feeling symptoms of fever, chills, eyes burning, but temp was 98.2. By 9pm severe chills, involuntary shaking, teeth chattering, still 98.2. Unable to relax due to chills & shaking. 1am got up & retook temperature currently 100.2. Eyes hurt & red, freezing, and goosebumps. Achy & uncomfortable. Headache. Still continuing.


VAERS ID: 1217056 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-02
Onset:2021-04-15
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Famotidine, Atorvastatin, Aspirin, Anoro Ellipta
Current Illness:
Preexisting Conditions: Hyperlipidemia, acid reflux disease, diastolic dysfunction without heart failure, COPD
Allergies: Sulfa drugs
Diagnostic Lab Data: 4/15/21 CT Chest showed acute subsegmental right lower lobe pulmonary embolism
CDC Split Type:

Write-up: Acute pulmonary embolism, first symptomatic on the evening of 4/15/21. Received first vaccine on 3/5/21, second vaccine on 4/2/21. Only other risk factors for PE are age and a long car trip around 3/14/21.


VAERS ID: 1217217 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Cold sweat, Nausea, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Shaking and chills, fever of 101.5, arm soreness, nausea when trying to stand or move, cold sweats


VAERS ID: 1217219 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Rash moving to different parts of the body, itching.


VAERS ID: 1217223 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Injection site swelling, Insomnia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Adderall IR 10 mg tablets, clonezapam 0.5 mg tablets, ketamine 200 mg troche
Current Illness: None.
Preexisting Conditions: Treatment Resistant Depression, PTSD, Generalized Anxiety Disorder
Allergies: NKA
Diagnostic Lab Data: I did not have any labs or tests done.
CDC Split Type:

Write-up: I had insomnia and a low grade fever. I also had pain and swelling at the injection site and fatigue. These symptoms began as at about 8:45 PM on 04/15/2021. I took 325 mg acetaminophen tablet at 09:00 PM and 02:00 AM. This helped reduce my fever and pain.


VAERS ID: 1217354 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, 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: Prescriptions: metformin, glimeperide, victoza, jardiance, ursodiol, protonix, carafate, b-12, singulair, losartan-hctz, atorvastatin OTC: Nasacort nasal spray Supplements: doTERRA Vitality Pack, doTERRA Bone Nutrient, doTERRA Phytoestrogen
Current Illness: none
Preexisting Conditions: diabetes type II, high blood pressure, fatty liver, sinusitis, GERD
Allergies: ampicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: low grade fever (100), body aches, tiredness


VAERS ID: 1217373 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Injection site pain, Loss of consciousness, Peripheral coldness, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Additional Details: AFTER 5 MINUTES OF BEING VACCINATED, PATIENT WAS SEATED WAINTING FOR THE 15 MINUTES AND FAINT LOSSING CONSCIOUSNESS FOR 5 MINUTES, THEN AFTER RECOVERED HE WAS PALE, SWEATING, COLDNESS OF THE HANDS AND DIZZY. WHEN 911 ARRIVED, HE SAID THAT HAD NOT EATEN ANYTHING SINCE 5:00 AM, 10 HOURS BEFORE THE EVENT HAD PLACE, SO MAYBE HE EXPERIENCED A HYPOGLYCEMIC EVENT.


VAERS ID: 1217662 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Hypoaesthesia, Lacunar stroke, Magnetic resonance imaging head abnormal
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: obesity s/p gastric sleeve, OSA, hypertension, hyperlipidemia
Allergies:
Diagnostic Lab Data: MRI brain on 4/15 showed left posterior parietal lobe CVA.
CDC Split Type:

Write-up: Patient presented 5 days after vaccine administration with a lacunar stroke. He had numbness in his right face and right hand which he woke up with on day 5.


VAERS ID: 1217667 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / SYR

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

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

Write-up: severe tinnitus onset at 35 hours (permanent and continious), chills started at 30 hours and lasted 6 hours


VAERS ID: 1217684 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Feeling hot, Flushing, Hyperhidrosis, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Flushed / Sweating-Mild, Additional Details: Patient complained of feeling hot, sweating noted. Skin cool and clammy. Vital signs 98.1, 72, 18, 110/90. Patient states that he does have anxiety and seeing the other incident in store caused reaction. Patient seen by EMS, refused transfer to ED for further evaluation. Patient given water to drink, tolerated well. Observed for 15 additional minutes and patient stated that he felt better. Then patient left store, appeared to stable, no further symptoms noted.


VAERS ID: 1217866 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-01
Onset:2021-04-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

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

Write-up: Systemic: Blood Disorder (diagnosed by MD)-Severe, Additional Details: Patient hospitalized for blood clot (called pharmacy @ 835pm on 4/15/21). Asked by hospital to contact pharmacy. Patient called from personal phone number.


VAERS ID: 1217906 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Periorbital swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swelling and puffiness in the face and around the eyes red face and fever. This occurred about 27 hours after the vaccine dosage for the Moderna COVID-19 vaccine.


VAERS ID: 1217939 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Pharyngeal swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lipitor Zyrtec-D Citalopram Trazodone Linzess Cholestyramine Protonix Metformin
Current Illness: n/a
Preexisting Conditions: Diabetes Hyperlipidemia Celiac Hypertension GERD Depression Seasonal Allergies
Allergies: Ciprofloxacin IV Contrast Dye Nitrofurantoin Prochlorperazine Doxycycline Azithromycin Cephalexin Fidaxomicin Levofloxacin Metoclopramide Penicillin Sulfa Vancomycin
Diagnostic Lab Data: Treatment. 2 ER Visits the same day. Hospital admission.
CDC Split Type:

Write-up: Anaphylaxis - throat swelling


VAERS ID: 1218104 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Cough, Differential white blood cell count, Dyspepsia, Dyspnoea, Full blood count, Headache, Metabolic function test, Myalgia, Nausea, Pruritus, Pyrexia, Respiratory tract congestion, Troponin, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: 4/15/21. Basic metabolic panel CBC with differential auto Chem8istat (lab) Troponin
CDC Split Type:

Write-up: 1 am, headache, congestion cough 2 am, fever, chills muscle soreness, 5 am nausea, 6 am itching 6:30, previous symptoms subside, breakout in hives, 7 am ems arrives, hives cover 35% of body 7:25 rapid onset heartburn, hives worsen 7:30 difficulty breathing 8:13 ER injects epinephrine, symptoms lessen immediately 8:28, ER gives IV Benadryl, Pepcid, and methyl prednisone 8:50, symptoms largely gone, hives still fading. ER monitors till 12pm


VAERS ID: 1218144 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Atelectasis, Chest X-ray abnormal, Chest pain, Computerised tomogram head, Computerised tomogram normal, Electrocardiogram normal, Full blood count normal, Headache, Hyperhidrosis, Hypertension, Malaise, Metabolic function test, Nausea, Pain in jaw, SARS-CoV-2 test negative, Troponin normal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Hypoglycaemia (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Humira
Current Illness: None reported
Preexisting Conditions: Hidradenitis suppurativa
Allergies: NKDA
Diagnostic Lab Data: EKG (4/15): NSR, rate 85 bpm, no ST elevation CBC/CMP (4/15): Unremarkable COVID-19 NAA (4/16): Negative Troponinx2 (4/15): <0.02 ng/mL CT brain w/o contrast (4/15): No acute intracranial process demonstrated CXR (4/15): Bibasilar atelectasis/early airspace disease
CDC Split Type:

Write-up: Within 15-minutes of vaccination, the patient reported headache, nausea, and malaise. Paramedics evaluated the patient on-site. The patient was hypertensive (229/129). EKG demonstrated NSR, rate 85 bpm, no ST elevation. Paramedics transported the patient to Emergency Department. In the ED, the patient developed centralized chest pain, diaphoresis, and right jaw pain, but denies shortness of breath, nausea/vomiting, focal weakness, fever or chills. The patient remained hypertensive (184/85). Physician administered 325mg PO Aspirin, 0.2mg PO Clonidine, and 1 inch topical Nitroglycerin. The labs and imaging did not present evidence of myocardial infarct or intracranial hemorrhage. Due to symptoms on presentation, the patient was admitted to rule out ACS. Upon admission, the patient stated the chest pain "comes and goes", but is not currently having any chest discomfort. Admitting physician administered 5mg PO Amlodipine, 5mg PO Lisinopril, labetalol 10mg IV, and prophylactic Lovenox. As of 4/16, the patient had not been discharged, but their hypertensive urgency and chest pain have resolved and will be treated outpatient. Internist planning patient''s discharge.


VAERS ID: 1218238 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-04-15
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood test, Computerised tomogram, Fibrin D dimer increased
SMQs:, Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad)

Life Threatening? Yes
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: Multi vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood works , CT
CDC Split Type:

Write-up: Back pain Elevated D dimer


VAERS ID: 1218628 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A/PUBLIC / 1 LA / IM

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

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

Write-up: Seen Emergency Services on 4/15/21 Dr: Diagnosis with Vaccine reaction, initial encounter, near syncope, frontal headache, evaluated for possible vaccine reaction, received J&J vaccine 6 days ago, now headaches and episodes vision blacks out, pt does not have any thrombocytopenia, D- dimer negative, at this time does not feel needs CT of head, if s/s worsening or changes, return for imaging, supportive care at home, discharged home, tylenol or ibuprofen for headaches as needed, return if changes or worsening.


VAERS ID: 1218682 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Computerised tomogram head, Computerised tomogram thorax normal, Fibrin D dimer increased, Full blood count, Metabolic function test, Postictal state, Seizure
SMQs:, Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Norco as needed for pain Synthroid Paxil
Current Illness: Right ankle surgery 4/13/21
Preexisting Conditions: Down Syndrome Dementia Hypothyroidism
Allergies: NKDA
Diagnostic Lab Data: CMP, CBC, ammonia, TSH, CT head, CTA Chest all normal 4/15/21 D-Dimer slightly elevated
CDC Split Type:

Write-up: Seizure on 4/15/21, 1-2 minutes, post-ictal for a few hours prior to return to baseline. No prior history of seizures.


VAERS ID: 1218698 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram head normal, Condition aggravated, Full blood count normal, Metabolic function test normal, Syncope, Troponin normal, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit D 2,000 unit daily Tums 500 mg TID PRN heartburn Excedrin extra strength 1 tab Q 8 hr PRN Ibuprofen 400 mg Q6 hrs PRN Advil Cold/Sinus 1 tab QD PRN
Current Illness: none
Preexisting Conditions: GERD Syncope
Allergies: no know allergies
Diagnostic Lab Data: 4/15/2021 - CBC, BMP, Troponin, Head CT. All within normal limits
CDC Split Type:

Write-up: Syncope event Vertigo


VAERS ID: 1218763 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-14
Onset:2021-04-15
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Cerebrovascular accident, Clumsiness, Computerised tomogram, Echocardiogram, Intensive care, Magnetic resonance imaging, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), 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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: None . Had COVID-19 6 months ago
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Received TPA, CT Scan. Will have another CT scan today, MRI, ECHO with cardiology consult . Is in ICU- doing well
CDC Split Type:

Write-up: 14 hours after vaccination patient experienced signs and symptoms of a stroke: aphasia, left arm weakness, clumsy, could not text. Called 911


VAERS ID: 1218781 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-01-04
Onset:2021-04-15
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cardiac failure congestive, Chronic obstructive pulmonary disease, Condition aggravated, Encephalopathy, Hypoxia, Intensive care, Respiratory symptom, SARS-CoV-2 test positive
SMQs:, Cardiac failure (narrow), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Respiratory failure (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol-ipratropium, amlodipine, apixaban, atorvastatin, calcium carbonate, carvedilol, divalproex, fentanyl, ferros sulfate, furosemide, gabapentin, glipizide, guaifenesin, insulin aspart, melatonin, metformin, multivitamin, omeprazole,
Current Illness:
Preexisting Conditions: VRE, OSA treated with BiPAP, hx MI, DM2, COPD, chronic pain, CAD
Allergies: Penicillins
Diagnostic Lab Data: Positive COVID-19 NP swab, PCR on 4/15/2021
CDC Split Type:

Write-up: Previously diagnosed with Covid PNA in 11/2020 that was treated with course of Remdesivir and steroids, has 2 negative covid tests in the interim. He received his first Moderna COVID vaccine on 1/4/2021, but did not get the second dose. He had recently been hospitalized at a healthcare provider for COPD/CHF exacerbation was discharged 4/13/2021, returned this morning with URI symptoms, found to by hypoxic with O2 sats in the 80s, encephalopathic, and Covid test was subsequently positive (4/15/2021). Pt transferred that evening to our hospital for ICU level care.


VAERS ID: 1218885 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-30
Onset:2021-04-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 UN / UN

Administered by: Public       Purchased by: ?
Symptoms: Cardiac failure congestive, Condition aggravated, Malaise, Pulmonary embolism
SMQs:, Cardiac failure (narrow), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, metoprolol, furosemide, Aldactone, lisinopril, trazodone, trintillex
Current Illness: Congestive Heart Failure
Preexisting Conditions: CHF, meth abuse, hyperlipidemia
Allergies: naproxen, sulfamethoxazole-trimethoprim
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient claims to have received the J and J vaccine on 3/30. He also claims it was his "second shot". He says he has felt ill since this shot, had an admission to the hospital and discharge for CHF. On 4/15, admitted again with Bilateral pulmonary emboli. He says the only thing he has done differently is vaccine.


VAERS ID: 1218965 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-13
Onset:2021-04-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary normal, Blood lactic acid normal, COVID-19, Cardiac arrest, Chest pain, Computerised tomogram head normal, Computerised tomogram thorax normal, Drug screen negative, Electrocardiogram abnormal, Electroencephalogram, Endotracheal intubation, Extubation, Foaming at mouth, Lumbar puncture, Magnetic resonance imaging head normal, Resuscitation, SARS-CoV-2 test positive, Seizure, Shock, Sinus tachycardia, Unresponsive to stimuli, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No medications listed on admission
Current Illness:
Preexisting Conditions:
Allergies: no known allergies
Diagnostic Lab Data: CT head on 4/15/2021: normal MRI head on 4/15/2021: unremarkable MRI venous head without contrast: unremarkable CT angio: no evidence of pulmonary embolism EKG 4/15/2021 at 14:26: sinus tachycardia EEG and LP pending at this Urine drug screen: negative Lactate 4/15: 6.8 at 13:21 and then 1.5 18:32
CDC Split Type:

Write-up: Per provider notes, 26-year old male was brought to the emergency room after he had an out of the hospital cardiac arrest/seizure. Mother of patient provided initial history. Patient received his first COVID vaccine 2 days ago and the next day he started complaining of some chest pain. Patient woke up on the 15th, mother made breakfast and acting normal. Mother went up to room and found him unresponsive foaming at the mouth and may have been shaking. Paramedics arrived and started CPR and noted he was in V fib and shocked once into an organized rhythm. Patient experienced another seizure in the ED. Patient''s family was positive for COVID in January. Patient was tested then and tested positive at hospital. Cycle threshold was 39.9. Patient was intubated initially yet extubated on 4/16/2021


VAERS ID: 1219069 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Jugular vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No home meds listed. Patient traveled from Mexico to receive the COVID-19 vaccine.
Current Illness: No significant medical history. Patient has no home meds. And has a past medical history of appendectomy.
Preexisting Conditions: No
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient has been admitted to the hospital on 4/15/21 with a right sigmoid sinus/jugular vein thrombus.


VAERS ID: 1219079 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Computerised tomogram, Fatigue, Myalgia, Palpitations, Pericarditis, Tachycardia, Troponin
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: see above
CDC Split Type:

Write-up: pt had transient fatique and myalgias on 4/8 post vaccination. adm 4/15 with chest tightness and palpitations; found to have suspected polymorphic VT/wide complex tachycardia and pericarditis. otherwise healthy young adult with no med hx. CTA neg for PE. given amiodarone. echo normal LVF. troponins normal arrhythmia resolved to be discharge today


VAERS ID: 1219132 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Chest pain/pressure


VAERS ID: 1219184 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose abnormal, Fatigue, Increased insulin requirement, Lethargy, Pain
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Lipodystrophy (broad), Hypoglycaemia (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? No
Previous Vaccinations: Flu vaccine
Other Medications: None
Current Illness: None
Preexisting Conditions: Type 1 Diabetes
Allergies: None
Diagnostic Lab Data: I don?t have health insurance so will not be going to the doctor or emergency room.
CDC Split Type:

Write-up: Sugar spiked off the charts. Had to take triple my normal insulin amount and still could bring down below 300. Also, feel tired, lethargic and achy.


VAERS ID: 1219245 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-25
Onset:2021-04-15
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Computerised tomogram thorax, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad)

Life Threatening? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CTA Chest
CDC Split Type:

Write-up: Pulmonary embolism


VAERS ID: 1219269 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-04-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Brain operation, Carotid artery occlusion, Cerebrovascular accident, Magnetic resonance imaging head abnormal, Paralysis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cholesterol meds, high blood pressure meds, pancreatic enzymes
Current Illness: No
Preexisting Conditions: Bad knees, high blood pressure
Allergies: No
Diagnostic Lab Data: femeral artery to remove blockage, MRI, brain operation...various tests etc for stroke and blood clots and blockages
CDC Split Type:

Write-up: This was the Johnson and Johnson one shot. My mother received it and today is in the hospital with acculsive blockage in left brain, paralyzed from stroke and is being operated on. I believe it is a blockage from the vaccine. She was old but extremely cognizant, independent, healthy, strong of sound mind. This is why I am reporting it. If she dies I will report again.


VAERS ID: 1219465 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-13
Onset:2021-04-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bilevel positive airway pressure, Blood bicarbonate increased, Blood creatinine increased, Blood gases abnormal, Blood urea increased, Brain natriuretic peptide increased, Cardiac failure, Chest X-ray abnormal, Dyspnoea, Fibrin D dimer increased, Fluid overload, Neutrophil percentage increased, PCO2 increased, PO2 decreased, Pleural effusion, Pulmonary congestion, Respiratory distress, Troponin increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rivaroxaban, Lipitor, Aspirin EC, Cephalexin, Plavix, Prednisone, Amiodarone, Torsemide, Insulin - Novolog, Metoprolol, Insulin Gargine
Current Illness: unknown
Preexisting Conditions: Diabetes, CAD, Hx. on non-stemi MI, A-fib, CHF, PVD, CVA, Femoropopliteal hx., recent PE, all complicated by continuous tabacco use, COPD, recent status post pacemaker insertion.
Allergies: NKA
Diagnostic Lab Data: WBC- 15.8, Neutrophil %- 75.5%; D-dimer - 4132, ABG''s - PCo2- 52.6, PO2- 59.5 Hco3 - 29.5, BUN - 31, Creatinine -1.7, Troponin - 57, BNP - 13821. CXR - shows pulmonary vascular congestion, with small bil. pleural effusions. Correlates for clinical signs of heart failure and overload.
CDC Split Type:

Write-up: on 4/15 pt. presents to local ED with c/o SOB. Husband poor hx. but reports that pt. was not taking medications as prescribed. Documentation from MD in ED uncertain if pt. taking her amiodarone, torsemide and elquis. Noted to have O2 sats on RA of 81%. Pt. was in respiratory distress upon arrival to ER. Pt. was transferred to higher level of care, another Hospital on 4/15/2021 placed on Bipap.


VAERS ID: 1219526 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral, Blood culture, Chest X-ray, Computerised tomogram head, Full blood count, Magnetic resonance imaging head, Metabolic function test, Transient global amnesia, Urine analysis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT/CTA/MRI brain, CBC, BMP, troponin, blood culture, UA, CXR
CDC Split Type:

Write-up: Transient global amnesia that onset within 24 hours of receiving the vaccine


VAERS ID: 1219550 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 205A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Deep vein thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Arthritis (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: OTC & Supplements: Zyrtec 10mg - 2 times daily for seasonal allergies Mag-OX (Magnesium Oxide) 400 mg - 1 time daily Potassium 99 mg - 1 time daily Prescription: Lisinopril 20 mg - 1 time daily
Current Illness: High blood pressure BMI greater than 30
Preexisting Conditions: High blood pressure BMI greater than 30
Allergies: NKA
Diagnostic Lab Data: Patient had a US lower extremity venous duplex ultrasound on the right leg and was diagnosed with deep venous thrombosis within right popliteal and peroneal veins. Blood work was also retrieved as to determine potential onset related to COVID vaccine and platelet count was 217 which is within the normal range for the patient.
CDC Split Type:

Write-up: On 4/15 - patient presented with dull ache/pain behind right knee and sought medical treatment to address and diagnose possible issues.


VAERS ID: 1219661 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN A43A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Feeling cold, Injection site movement impairment, Mobility decreased, Pruritus
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: After vaccine left arm was unable to move like 5 minutes. 12 hrs - 48 hours fever up to 101. pain in Joints, chills and exhaustion. Thursday after the vaccine itchiness in scalp , around 8 itchines in face . today is Friday at 14:00 almost a week after the shot and my whole body is itching. Not at a pain that i can not resist but maybe from 1-10 a number 4.


VAERS ID: 1219721 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiocardiogram, Chest discomfort, Echocardiogram, Electrocardiogram ST segment elevation, Myocarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), 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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ekg, troponin, coronary angiogram, echocardiogram
CDC Split Type:

Write-up: developed chest discomfort presented to hospital ER. ekg w diffuse st elevations, elevated troponin. taken for coronary angiogram negative for cad. normal echo. diagnosed w myocarditis. no evident viral prodrome or other inciting cause.


VAERS ID: 1219878 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-04-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Arterial rupture, Full blood count, Headache, Platelet count normal, Subarachnoid haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ferrous sulfate, losartan, omeprazole, verapamil, vitamin C
Current Illness: Shoulder pain, probably rotator cuff tendonitis
Preexisting Conditions: Hypertension with left ventricular hypertrophy, obesity, iron deficiency anemia, menorrhagia and uterine leiomyoma, tobacco abuse, chronic constipation, GERD, hypersomnolence, major depressive disorder
Allergies: None
Diagnostic Lab Data: CT angiogram 4/15/2021. Normal platelets on CBC.
CDC Split Type:

Write-up: Date of vaccine 4/5/2021. Date of adverse event: 4/15/2021 acute onset of worst headache of life and imaging consistent w/ subarachnoid hemorrhage likely from rupture of anterior communicating artery rupture. She was seen in ER and transferred to Hospital and is admitted, awaiting cerebral angiography. Has not had an intervention. Available records will be faxed today to your fax number listed.


VAERS ID: 1220034 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-11
Onset:2021-04-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily Flonase and Zyrtec, occ Advil, daily multi vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Environmental allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Abnormal menstruation, heavy bleeding.


VAERS ID: 1220068 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-06
Onset:2021-04-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Anticoagulant therapy, Blood lactic acid, Body temperature increased, Chest pain, Computerised tomogram thorax abnormal, Cough, Electrocardiogram, Fibrin D dimer increased, Full blood count, Malaise, Metabolic function test, Pneumonia, Prothrombin level, Pulmonary thrombosis, Pyrexia, SARS-CoV-2 test, Scan with contrast abnormal, Troponin, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: received Vaccine at
Current Illness: I do not have access to the vaccine form
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: CBC, PT/PTT, Troponin, CMP, D Dimer, Lactic Acid, Rapid COVID (4/15/21) EKG (4/15/21) CT with contrast (4/15/21)
CDC Split Type:

Write-up: Pt had right sided chest pain x3 days starting 4/12/21, had a week of cough, fever, "general not feeling well" prior to ER admission 4/15/21. Had CT scan in ER on 4/15/21 - per radiology report a clot and pneumonia noted in RUL of lung. WBC count $g22, elevated D Dimer, T Max in ER was 102.2. Was given PO Tylenol, 100mg Lovenox Subq, and IV antibiotics and flown to hospital.


VAERS ID: 1220180 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-14
Onset:2021-04-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Oropharyngeal pain, Pain, Pain in extremity
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: arthritis
Allergies: sulfer
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore throat, arm, aching, chills


VAERS ID: 1220359 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-05
Onset:2021-04-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis, Cerebrovascular accident, Computerised tomogram abnormal, Intensive care, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (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: Crestor 40 mg daily
Current Illness:
Preexisting Conditions: uncontrolled hyperlipidemia, hypertension, physical inactivity (BMI 76)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted 4/14/2021 to the ICU from ED. Patient was experiencing hand weakness. Patient given TPA as treatment for a potential stroke. Patient with known stroke on CT imaging, unable to further verify with MRI imaging. Upon further investigation/discussion with the patient, he reports receiving the Johnson & Johnson Vaccine 10 days prior to admission. Patient with known comorbidities which increase his risk of an embolitic stroke however with recent findings from the CDC, unsure if this needs to be further investigated. Patient had 2 head CT scans, showing no intracranial abnormalities and MRI was unable to be completed due to patient''s size. Neurology states high probability of stroke within their consult note. Patient''s risk factors for stroke include: uncontrolled hyperlipidemia (LDL 132 on Crestor 40 mg daily PTA), hypertension (as high as 182/92 mmHg in ED), physical inactivity (BMI 76 kg/m^2), and male. Low suspicion of CVST based on patient''s platelet count of 212 on admission and no abnormality on head CT. MRI would have been beneficial in potentially diagnosing CVST, as well. Our recommendation is to submit this information to the VAERS database as a possible ADR from the vaccine. The patient fits the timing of an ADR, within 6-13 days of vaccine administration, and CDC recommends watching for neurological symptoms based on their most recent press release.


VAERS ID: 1220393 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache started 2 to 3 days after vaccination, Patient had fever for 2 days. Patient''s arm feeling sore and heavy at the injection site. Patient is feeling better 5 days after vaccination. Patient consulted the doctor regarding her symptoms.


VAERS ID: 1220785 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Induration, Musculoskeletal discomfort, Pain, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Felt some irritation near the upper middle of my back my spouse checked it out and it is hard to see.What I can see and my spouse is a 7x7 inch bumps spread across area.Some pain not much itching .I''m postive it''s a reaction to shot first time iv ever had this happen.Im very healthy good skin no new products in used.Im feel like it''s a reaction.Keeping Close eye on it.Useing hydrocortisone cream at this time.Thank you .I was asked by My local Health Dept to Contact you.


VAERS ID: 1220995 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Laboratory test, Muscle spasms, Pain in extremity
SMQs:, Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Red yeast rice 1200 Mg
Current Illness: No illnesses
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Pending.
CDC Split Type:

Write-up: The injection site is the left arm. Common pain was felt, however, pain sensation traveled down below the left elbow. Persistent muscle cramping is experienced with the calf muscles of both legs. A routine of stretching and daily mile walk before and after vaccination has not eliminated the pain.


VAERS ID: 1221028 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram normal, Dyspnoea, Fibrin D dimer, Headache
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Generic Lexapro Xolair
Current Illness: N/A
Preexisting Conditions: Asthma, idiopathic angioedema
Allergies: Allergic to: singulair, advair, gabapentin, hydroxycholorquine
Diagnostic Lab Data: D dimer was positive CT scan was negative
CDC Split Type:

Write-up: Started about 11:30am on April 16th, shortness of breath, heart rate in the 120s, chest pain, and headache I called my campus health services and they instructed me to go to the ER. I had a positive d dimer and was given a contrast CT scan which turned out negative for blood clots. Still experiencing the same symptoms as of 8:30pm April 17th.


VAERS ID: 1221071 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-05
Onset:2021-04-15
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Computerised tomogram head, Ear pain, Full blood count, Headache, Hypoaesthesia, Lymph node pain, Metabolic function test, Neck pain, Paraesthesia, Pharyngeal paraesthesia, Spinal X-ray abnormal
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Hypertension, Hyperlipidemia, IGT, OA, GERD, Osteopenia, Cervical Spondylosis
Preexisting Conditions: Same as Item 11
Allergies: None
Diagnostic Lab Data: CBC, CMP on 3/15/21 are WNL X-Ray of C-Spine on 3/19/21: Spondylosis CT of Sinus on 3/29/21: Left Mastoid Opacification CT of Head on 4/8/21: Negative
CDC Split Type:

Write-up: Pain at left side of head, neck and ear with tender lymph nodes and "throat feels funny", few days later "legs feel funny" with numbness sensation


VAERS ID: 1221298 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Fibrin D dimer increased, Pulmonary embolism, Ultrasound Doppler
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NP thyroid 60mg progesterone/estrogen unknown dose
Current Illness: None
Preexisting Conditions: hypothyroidisim
Allergies: penicillin, tetracycline, erythromycin
Diagnostic Lab Data: CT angio: + PE LE Duplex US: negative D-dimer: positive
CDC Split Type:

Write-up: Large saddle pulmonary embolism. No DVT. Patient stable, hospitalized. Form competed upon admission, unknown duration of hospitalization at this time


VAERS ID: 1221393 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Mobility decreased, Pain, Urinary tract infection, Urine analysis, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Parkinson-like events (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, botox, feverfew, cbd+curcumin daily As needed abortive migraine medications and tizanidine
Current Illness:
Preexisting Conditions: Chronic migraine, chronic kidney stones, grade 5 urinary reflux, reynauds disease
Allergies: Imitrex, morphine
Diagnostic Lab Data: Urinalysis - UTI. Had no symptoms of this.
CDC Split Type:

Write-up: Suddenly developed moderate hives/welts on back. Spread to abdomen and chest, then neck and face withing 30 minutes. Was prescribed decreasing dose of prednisone. This was the morning of the 15th. As the day went on my thighs (both, very high up near groin) started aching. Uncomfortable to walk or sit for long periods. Getting worse as today, the 16th, has gone on. My hips are very achy and sore today. Hives have finally subsided.


VAERS ID: 1221509 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18808609 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Disturbance in attention, Headache, Muscle spasms, Pain in extremity
SMQs:, Dystonia (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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:
Current Illness:
Preexisting Conditions:
Allergies: Penecillin, shellfish, grass
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bad headache in morning. Very unusual for me. In my eyes. Hard to concentrate on work at computer. After an hour took a short nap and completely went away. Several days before had sharp pain in my calf but thought it could be a muscle cramp. That was also very unusual.


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