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From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 33 out of 8,010

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VAERS ID: 1766156 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (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: Raloxifene 60 mg Montelukast 10 mg Lamotrigine 100 mg Levothyroxine 25 might Fluticasone propionate 113/14 mcg
Current Illness:
Preexisting Conditions: Asthma hypothyroidism
Allergies: Squid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain underarm swollen near right breast


VAERS ID: 1766160 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Chest discomfort, Chest pain, Dry mouth, Dyspnoea, Hypoaesthesia oral, Migraine, Pain in extremity, Palpitations, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

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

Write-up: sharp pains in legs and arms- 2 days burning in the spine- 1 day -now its sore pressure in the chest with heart palpitations and shortness of breath- 2 incidents excruciating migrane- 2nd day burning in the arm of the vaccine shot- 2 days dry month and numb lips- 1st day pain in joints- knees and ankles - 2 days


VAERS ID: 1766314 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Back pain, Lymphadenopathy, Neck pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm and started an hour after shot Pain worsened and spread to entire arm, back, neck 12 hours after injection Axillary pain and lymphadenopathy started 24-36 hours later on same arm


VAERS ID: 1766326 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Peripheral swelling, 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 (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: Moderna, July 3, 2021 Right arm slight erythema, swelling.
Other Medications:
Current Illness: Cold virus-Covid negative
Preexisting Conditions: Fibromyalgia
Allergies: Tramadol
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Heat, erythema and swelling the size of tennis ball to right arm post vaccination.


VAERS ID: 1766443 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Similar rxn after 2nd dose
Other Medications: Escitalopram Pantoprazole Tadafanil Modafanil Tempazepam
Current Illness: ~5 weeks post op THD Complicated by ongoing urinary retention
Preexisting Conditions: Anxiety/depression/insomnia Severe GERD
Allergies: Reglan Lovaquin Shelly fish
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe weakness Myalagia Fever to ~102 Headache


VAERS ID: 1766448 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metronidazole 50 mg twice daily for 7 days, began Sunday 10/3/21, fluconazola taken Sunday 10/3/21 and Wednesday 10/6/21, over the counter Azo. The patient also received a flu shot at the time that the Covid Booster was administered.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2.5 inch (at time of report) red, raised, hot to the touch, hard bump which has increased in size.


VAERS ID: 1766861 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-10-05
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No known allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211009088

Write-up: EXTRA DOSE ADMINISTERED; This spontaneous report received from a health care professional concerned a 67 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: No known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820096, expiry: 21-OCT-2021) dose was not reported, administered on 05-OCT-2021 for prophylactic vaccination. No concomitant medications were reported. On 05-OCT-2021, the patient experienced extra dose administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of extra dose administered was not reported. This report was non-serious.


VAERS ID: 1767141 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis, Impaired work ability, Injection site pain, Night sweats
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (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: Valtrex Vitamin D vitamin C Women?s multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish Adhesive medical tape
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10/5/2021: chills, soreness injection site, headache, fatigue (12am) 6am: severe fatigue chills stayed home from work. Could not get out of bed until noon. Took 1g Tylenol did not help at 6am. Entire day chills fatigue 10-5-2021 10-6-2021: night sweats and day sweats but able to go to work and do daily activities 10-7-2021: 2am night sweat drenched


VAERS ID: 1767144 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-29
Onset:2021-10-05
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Erythema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (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: Adderall 30mg x 3, Lisinipril 40 mg, Zyrtec, Odefsey
Current Illness:
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Broke out in a full body rash 5 days later. Itching most intense on palms of hands. Redness, burning, severe itching with little relief.


VAERS ID: 1767627 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-10-05
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal tenderness, Adenovirus test, Arteriosclerosis, Asthenia, Atelectasis, Bladder dilatation, Blood alkaline phosphatase increased, Blood glucose normal, Blood magnesium normal, Blood phosphorus normal, Blood sodium decreased, Bordetella test negative, COVID-19, Cerebral atrophy, Chest X-ray abnormal, Chlamydia test negative, Clostridium difficile infection, Colectomy, Computerised tomogram abdomen, Computerised tomogram head abnormal, Coronavirus test negative, Cough, Diarrhoea, Electrocardiogram normal, Enterovirus test negative, Faeces discoloured, Fall, Feeding disorder, Full blood count normal, Human metapneumovirus test, Human rhinovirus test, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Intestinal anastomosis, Lung opacity, Metabolic function test, Mycoplasma test negative, Nausea, Nephrolithiasis, Osteoma, Pneumobilia, Respiratory syncytial virus test negative, Retching, SARS-CoV-2 test positive, Scan with contrast, Spinal compression fracture, Urine analysis normal, Vomiting
SMQs:, Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), Dementia (broad), Pseudomembranous colitis (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteoporosis/osteopenia (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications acetaminophen-codeine (TYLENOL/CODEINE #3) 300-30 MG per tablet aspirin 81 MG enteric coated tablet Continuous Blood Gluc Sensor (DEXCOM G6 SENSOR) MISC Continuous Blood Gluc Transmit (DEXCOM G6 TRANSMITTER) MISC fina
Current Illness: cystoscopy, right ureteroscopy, laser lithotripsy, stone basket extraction, right ureteral stent exchange 3/25/2021 Osteoporosis with current pathological fracture, unspecified osteoporosis type, sequela 3/5/2021
Preexisting Conditions: Hospital Type 1 diabetes mellitus without complication, with long-term current use of insulin Unspecified severe protein-calorie malnutrition Failure to thrive in adult Dehydration Non-Hospital Stomatitis and mucositis with change of taste Mixed hyperlipidemia Insulin pump status: Tandem T-Slim X2 with Dexcom G6 continuous glucose monitor Gastric motility disorder Hyperlipidemia type II Duodenal ulcer, unspecified as acute or chronic, without hemorrhage, perforation, or obstruction Benign tumor of muscle OA (osteoarthritis) Vitamin D deficiency Regular astigmatism Moderate episode of recurrent major depressive disorder (HCC) History of malignant neoplasm of ampulla of Vater Chronic left-sided low back pain without sciatica Abnormal EKG Dyspnea Personal history of tobacco use, presenting hazards to health Coronary artery disease involving native coronary artery of native heart without angina pectoris Malignant neoplasm of posterior wall of urinary bladder (HCC) Renal colic Dumping syndrome Dehydration
Allergies: Penicillin G BenzathineRash Penicillins
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time CT ABDOMEN AND PELVIS WITH IV CONTRAST Resulted: 10/06/21 0039 Order Status: Completed Updated: 10/06/21 0042 Narrative: EXAMINATION: CT Abdomen and Pelvis with IV Contrast EXAM DATE: 10/5/2021 11:49 PM TECHNIQUE: CT imaging of the abdomen and pelvis was performed with intravenous contrast. Coronal and sagittal images were reconstructed. CONTRAST: The amount and type of contrast are recorded in the medical record. QPP DOCUMENTATION: At least one of the following dose reduction techniques was utilized: Iterative reconstruction, and/or Automatic Exposure Control, and/or mA/kV adjustment based on body size. INDICATION: abdominal pain, intractable nausea, recent c. diff. hx of adenocarcinoma of ampulla of vater COMPARISON: CT abdomen pelvis dated September 20, 2021 FINDINGS: Lung Bases: There is dependent atelectasis at the included extent of the lung bases. Hepatobiliary: Pneumobilia remains throughout the left lobe. The liver is otherwise unremarkable. The portal and hepatic veins are patent. Pancreas: A small amount of gas is also present within the main pancreatic duct in the head of the pancreas which was seen previously. The pancreas is otherwise unremarkable. Spleen: The spleen has a normal size and there are no splenic lesions. Adrenals: The adrenal glands are normal. Kidneys, Ureters, & Bladder: Both kidneys have a normal size and there is no hydronephrosis. There is a 5 mm nonobstructing stone at the inferior pole of the right kidney. Both ureters have a normal caliber. Urinary bladder is modestly distended. Gastrointestinal: The stomach and small bowel are normal with no obstruction or inflammation. The patient had a colectomy with J-pouch and ileoanal anastomosis. There is no evidence of associated complication. Reproductive Organs: Unremarkable. Lymphatic System: There is no lymph node enlargement within the abdomen or pelvis. Vasculature: Normal caliber abdominal aorta with significant atherosclerotic disease. There is mild atherosclerotic plaque at the origins of the mesenteric vessels with no evidence for a significant narrowing. The mesenteric veins are normal. Peritoneum: No free fluid, free air, or inflammation. Abdominal Wall & Musculoskeletal: There is stable significant compression fractures of L1-L2 and a moderate compression fracture of the superior endplate of L3. Impression: 1. There is no acute abdominal or pelvic abnormality. No bowel inflammation or obstruction is identified 2. Urinary bladder is moderately distended which could be due to chronic outflow obstruction and clinical correlation is suggested 3. Stable residual 5 mm nonobstructing right renal stone. There is no hydronephrosis and no residual ureteral calculi are present DR CHEST 2 VIEWS FRONTAL AND LATERAL Resulted: 10/05/21 1440 Order Status: Completed Updated: 10/05/21 1442 Narrative: EXAMINATION: Frontal and Lateral View Chest EXAM DATE: 10/5/2021 1:53 PM TECHNIQUE: Frontal and lateral views INDICATION: cough X 1 week. COMPARISON: 9/20/2021 chest x-ray and 7/16/2021 CT thorax abdomen and pelvis Impression: Persistent right upper lobe opacity may be related to ongoing infection. Follow-up imaging one month post treatment is suggested to document resolution. Similar apical scarring. No pleural effusion or pneumothorax is seen. The cardiac silhouette appears normal in size. CT HEAD WITHOUT IV CONTRAST Resulted: 10/05/21 1351 Order Status: Completed Updated: 10/05/21 1353 Narrative: EXAMINATION: CT HEAD WITHOUT IV CONTRAST EXAM DATE: 10/5/2021 1:41 PM TECHNIQUE: Routine protocol CT images of the head were obtained without intravenous contrast. INDICATION: 80-year-old status post fall, possible loss of consciousness. COMPARISON: CT brain dated November 15, 2007 HAND DOMINANCE: Right QPP DOCUMENTATION: At least one of the following dose reduction techniques was utilized: Iterative reconstruction, and/or automatic exposure control, and/or mA/kV adjustments based on body size. FINDINGS: There is mild intracranial volume loss. There is no midline shift or hydrocephalus. The basal cisterns are patent. There is no acute intracranial hemorrhage or pathologic extra-axial collection. Scattered areas of low attenuation are present within the periventricular and subcortical white matter, a nonspecific finding that likely represents small vessel ischemic change. Atherosclerotic plaque is noted within the intracranial vasculature. The calvarium is intact. There is a right parietal calvarial bony excrescence likely representing an osteoma, of no clinical significance (series 3, image 40). The mastoid air cells and visualized portions of the paranasal sinuses are clear. There are bilateral ocular lens implants. Impression: 1. No acute intracranial hemorrhage. 2. Mild intracranial volume loss and small vessel ischemic change. Procedure Component Value Ref Range Date/Time Respiratory Pathogens (Abnormal) Collected: 10/05/21 1649 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 10/05/21 1831 Adenovirus PCR Not Detected Not Detected Coronavirus 229E PCR Not Detected Not Detected Coronavirus HKU1 PCR Not Detected Not Detected Coronavirus NL63 PCR Not Detected Not Detected Coronavirus OC43 PCR Not Detected Not Detected COVID-19 PCR Detected Abnormal Not Detected Comment: COVID-19 (SARS-CoV-2) test is positive. Clinical correlation with patient history and other diagnostic information is necessary to determine infection status. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms. Metapneumovirus PCR Not Detected Not Detected Rhinovirus-Enterovirus PCR Not Detected Not Detected Influenza A PCR Not Detected Not Detected Influenza A H3 PCR Not Detected Not Detected Influenza A H1 PCR Not Detected Not Detected Influenza A 2009 H1 PCR Not Detected Not Detected Influenza B PCR Not Detected Not Detected Parainfluenza 1 PCR Not Detected Not Detected Parainfluenza 2 PCR Not Detected Not Detected Parainfluenza 3 PCR Not Detected Not Detected Parainfluenza 4 PCR Not Detected Not Detected Respiratory Syncytial Virus PCR Not Detected Not Detected Bordetella pertussis PCR Not Detected Not Detected Bordetella parapertussis PCR Not Detected Not Detected Chlamydia pneumoniae PCR Not Detected Not Detected Mycoplasma pneumoniae PCR Not Detected Not Detected COVID-19 PCR (Abnormal) Collected: 10/05/21 1431 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 10/05/21 1523
CDC Split Type:

Write-up: Patient is a 80 y.o. male with past medical history significant for type 1 diabetes mellitus, with insulin pump, dumping syndrome, prior TIA, history of ampullary cancer, who presents to the emergency department today for evaluation of generalized weakness, multiple falls at home, and intractable nausea, vomiting. He was recently admitted to the emergency department observation unit for similar symptoms, was found to have C difficile, and has since completed 10 days of oral vancomycin. Since completing antibiotics, he reports significant improvement in diarrhea, but still having some. He reports dark brown bowel movements, denies tarry black stools or hematochezia. He reports severe nausea and vomiting to the point of dry heaving. Has not been able to eat any food over the past 24 hours secondary to this. He does normally receive biweekly IV fluid infusions, but has required many increased infusions recently due to GI losses. His nausea and vomiting is worse with palpation of the abdomen and with position changes. He is tender with palpation of his abdomen. Denies fevers, chills. He does report slight cough, but no significant dyspnea. No chest pain. No urinary symptoms. The patient arrived in the emergency department hemodynamically stable, afebrile and non-hypoxic on room air. CBC was unremarkable. CMP was remarkable for Na 133, glucose 119, alk phos 153. Mag and phos were normal. hstnt baseline 16, hstnt 2hr 15 (delta - 1). The patient denies chest pain. UA was unremarkable. EKG was obtained and independently reviewed, with normal sinus rhythm, rate 83, QTC 415, no ischemic changes. Chest x-ray was independently reviewed, with persistent right upper lobe opacity, similar apical scarring to past CXRs. CT head was independently reviewed, with mild intracranial volume loss and chronic small-vessel changes. The patient was given 1 L normal saline, 4 mg IV Zofran. The patient was admitted to the hospitalist service for further workup and management.


VAERS ID: 1767768 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Heart rate increased, Pain, Palpitations, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega 3, multi vitamin, vitamin d, collagen
Current Illness:
Preexisting Conditions: Osler-Weber-Rendu disease
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, vomiting, headache, fatigue, body aches, racing heart rate, heart palpitations for about 24 hrs. Rest & Tylenol


VAERS ID: 1767957 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache
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: second Covid vaccine
Other Medications: cholesterol medication High blood pressure medicaton
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever (100 degrees), chills, severe headache


VAERS ID: 1767960 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-10-03
Onset:2021-10-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Edema under left arm and soreness


VAERS ID: 1767965 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Extra dose administered, Headache, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer
Other Medications: Colestipol 1gm 2daily Protonix 40 mg 1daily Losartan /HCTZ 50-12.5 mg 1 daily Zoloft (Sertraline) 50 mg 1 daily Advil 200 mg
Current Illness: N/A
Preexisting Conditions: high blood pressure
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: chills, body aches, fever, bad headache, nausea 30 hours


VAERS ID: 1767977 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Pallor, Presyncope, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Pt stated prior to vaccine, "I''m very nervous, and sometimes I have panic attacks when I have medical procedures done." Pt had a near-syncope vasovagal response. Pt was sitting up in chair, talking to this nurse, when he stated "Yeah, I think I''m going to have a panic attack with this one." Pt sat on floor, with legs crossed et stated he felt dizzy, asked this nurse if she could hold on to his hand. While this nurse was holding pt''s hand, pt began squeezing hand et started to shake, pt was also very diaphoretic. This nurse asked other nurse to get pt a bottle of water, when other nurse returned to room, she instructed pt to uncross his legs to help increase blood flow. Pt did then asked if he could lay down on floor, both nurses stated yes. Pt layed on floor, et was very pale in color. Nurse began to ''fan'' pt with paper, et talked to pt, color began to slowly return to pt''s face. Pt stated he was feeling better, sat up again et drank some water. Pt stated he was feeling much better at the end of visit.


VAERS ID: 1767983 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-10-05
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: I began bleeding and ovulating out of my normal cycle. I have been bleeding non stop for about 2 weeks now. One being my regular cycle and then it was over. About 2 days later after the shot, I began bleeding again. Today, I am having heavy cramping and discharge. I have always had a regular period so this is abnormal.


VAERS ID: 1768000 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-03
Onset:2021-10-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary mass, Neck mass
SMQs:

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

Write-up: Lump under armpit and on side of neck


VAERS ID: 1768004 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Back pain, Chills, Cold sweat, Dizziness, Eye irritation, Fatigue, Hyperhidrosis, Pain, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Corneal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Linsinopril-HCTZ Proventil Inhaler
Current Illness: none
Preexisting Conditions: Hypertension Asthma
Allergies: Adhesive Tape
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Less than 24 hours after IM vaccine of 3rd dose of COVID, developed chills, body aches, back pain that started at shoulders extending down back into legs, light headedness, "felt like eyes were on fire." Very fatigued and diaphoretic for 1 day after vaccine. Developed pain in axilla of left arm in the injection and left arm soreness. continues to have episodes of diaphoresis/clammy


VAERS ID: 1768011 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-10-02
Onset:2021-10-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

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

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

Write-up: Itchiness in extremities


VAERS ID: 1768016 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Back pain, Chills, Cold sweat, Eye irritation, Fatigue, Hyperhidrosis, Pain, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Corneal disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril/HZTC Proventil Inhale
Current Illness: none
Preexisting Conditions: HTN Asthma
Allergies: Adhesive Tape
Diagnostic Lab Data: none
CDC Split Type:

Write-up: less than 24 hours after 3rd COVID vaccine developed chills, body aches, pain from shoulders extending down back to legs, felt "like eyes were on fire." Very fatigued and very diaphoretic for 1 day. Developed left arm pain and pain in axilla of left arm. Continues to have episodes of diaphoresis and clamminess. Took Ibuprofen 800 mg PO three times for symptoms. Continues to have episodes of diaphoresis and clamminess. Continues to have pain in left axilla, which is improving.


VAERS ID: 1768040 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-24
Onset:2021-10-05
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cetirizine, cholecalciferol, estradiol (vaginal cream), famotidine, fenofibrate, fluticasone, advair diskus, gabapentin, metformin, metoprolol, omeprazole, polyethyl glycol ophthalmic solution.
Current Illness:
Preexisting Conditions: arrhythmia, arthritis, asthma, B-12 deficiency, basal cell carcinoma of skin, HX breast cancer with left masectomy, chronic rhinitis, CKD stage 3, DM, GERD, hyperlipemia, impingement syndrome of right shoulder, morbid obesity, paroxysmal atrial tachycardia, sleep apnea, trigger middle finger, tubular adenoma, vision loss
Allergies: Niacin, simvastatin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was fully vaccinated with the Pfizer COVID-19 vaccine (on 2/3/2021 and 2/24/2021 respectively). Pt was seen in the ED on 10/5/2021 and tested positive via PCR for COVID 19. She was transferred to hospital for admission, in general med/surg unit, to be treated for COVID.


VAERS ID: 1768045 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

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

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

Write-up: Fever, chills, extreme shivering


VAERS ID: 1768066 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Electrocardiogram normal, Fatigue, Feeling hot, Hyperhidrosis, Illness, Laboratory test normal, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril; Toprol; Phabrix; Protonix; Eliquis; Lipitor; Vitamin C; Vitamin D-3
Current Illness:
Preexisting Conditions: Cad
Allergies: Tetracycline
Diagnostic Lab Data: Ekg- negative, Routine lab work- normal. chest x-ray- normal.
CDC Split Type: vsafe

Write-up: After receiving my 3rd dose I felt very tired and all of a sudden I felt very hot. I started to sweat to the point people noticing. I looked very pale and sick. I went to the hospital to the emergency room and after 45 minutes the symptoms started to go away gradually. I received an ekg which came back negative, cardiac components- negative, routine lab work, a chest x-ray and everything came back normal.


VAERS ID: 1768082 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor 40mg daily; aspirin 81mg daily; dapagliflozin-metformin daily; trulicity; losartan 50mg daily; ibuprofen 800mg as needed
Current Illness: none
Preexisting Conditions: HTN, low testosterone, HLD, diabetes
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: the day he got the vaccine, he started having symptoms of light-headedness, frontal headache, fatigue, generalized body aches and these have progressed since getting vaccinated


VAERS ID: 1768087 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-18
Onset:2021-10-05
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017BZ1A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: history of developmental delay, schizoaffective disorder, morbid obesity, osteoarthritis, DVT
Allergies:
Diagnostic Lab Data: COVID positive on 10/5/2021
CDC Split Type:

Write-up: COVID vaccine breakthrough case


VAERS ID: 1768117 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexipro, Welbutrin, melatonin, ibuprofen
Current Illness: N/A
Preexisting Conditions: depression, anxiety, obesity
Allergies: amoxicillin, flaxseed
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, inflammation, tenderness around injection site. Marked around inflamed area with marker on day 3 and grew slightly by day 4.


VAERS ID: 1768143 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-10-05
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D Lorazepam Propanolol
Current Illness: None
Preexisting Conditions: Pre diabetes, Obesity
Allergies: Sulfa drugs, temazepam, Amitriptyline, gabapentin, estradol, Megestrol, Diclofenac, Bupropion
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vet came into clinic stating she wanted to be vaccinated. After writer administered vaccine, she stated she had the pfizer previously and it gave her a rash on her arm. Writer did not know she had received pfizer dose until after moderna dose was given. Vet reports headache today


VAERS ID: 1768171 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, vitamin D, Vitamin E, Vitamin B. Eliquis, Diltiazem, Fleconase, Omeprazole, Benazapril.
Current Illness: None.
Preexisting Conditions: A-Fib 8 months ago, on medication for it.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: She got her vaccine, that night she went to bed early as she was tired. At 1:30 AM she felt real weird and had a headache, and went back to sleep. Then she got up and was severely nauseated, didn''t eat anything. She then got really tired. Then she went to bed at 4:00 that afternoon due to the nausea, and by 9:00 PM she had a fever of 99.7. She went back to bed and the headache got more intense and the nausea kept going. At 1:30 she woke up and she was sweating to the point of dripping wet, and had to change her clothes. She took some Tylenol 650 mg to get rid of the headache, and went to sleep and woke up this morning and feeling fine. Never had any reactions from the other two vaccines or any other vaccines that she has had.


VAERS ID: 1768213 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, Metamucil, Whey protein, Orgain mega greens powder.
Current Illness: Tension Headaches
Preexisting Conditions: None
Allergies: No Known Allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain and swelling in right armpit (Axillary lymph nodes). Treatment: tyenol as directed for pain. Outcome: resolving on day 3 after day of injection.


VAERS ID: 1768214 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Cough, Dizziness, Injection site pain, Nausea, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Received Pfizer booster 10/5 in the morning, later in the afternoon started to experience nausea, dizziness, lightheadedness, weakness, chills, runny nose, cough, left arm sore at injection site.


VAERS ID: 1768265 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No. Not aware of at this time.
Allergies: Codeine
Diagnostic Lab Data: I have not seen a doctor for my reaction. I have looked up to see if this was a occurrence with the vaccine. So far I?ve read that it?s nothing to worry about but, I just want to make record of it that it?s happened with the third shot and my previous two shot before this had not caused me any symptoms or problems before.
CDC Split Type:

Write-up: On second day after shot, in evening, started to feel and notice swollen lymph nodes in armpit and shoulder/collar bone on right side of arm. This was for my booster shot, as I work in the hospital constantly in contact with newborns and their parents.


VAERS ID: 1768280 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 RA / IM

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

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

Write-up: Patient had received the Mederna Vaccine the first 2 doses of COVID 19 vaccine. Patient came in and received the Pfizer vaccine for COVID 19 . as the 3rd dose. Patient did not have any signs or symptoms of adverse reaction to having received the 3rd dose as the Pfizer rather than the Mederna.


VAERS ID: 1768309 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Chest discomfort, Chills, Dyspnoea, Fatigue, Flushing, Headache, Hot flush, Hyperhidrosis, Lethargy, Malaise, Nausea, Pain, Pain in extremity, Restlessness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid 15 Magnesium 400mg Fish oil 2000mg Iron 18mg Vitamin C 280mg Vitamin D 25 mcg Probiotics Multivitamin Ashwagandha 600 mg
Current Illness: None
Preexisting Conditions: Obesity
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10/5/2021 11:00 AM-Tired, tight chest. Sore arm. Body ache. Headache. Flushing 10/5/2021 4:30 PM-99.3 slight chills body ached 3 Advil improved 10/5/2021 8pm-chills, major aches legs, knees hips, shins. Arm pain. Slight headache. Tired. 3 Advil 10/6/2021 12am-shivering, chills, extreme aches in left knee, major aches in legs, hand joints. Tired but restless due to pain. 3 Advil, improved by did not stop ache in knee. Nausea 10:6/2021 3:30am-sweating, hot flashes, extreme aches in left knee, major aches in legs, hand joints. Tired. 2 Advil, improved by did not stop ache in knee. Nausea 10/6/2021 6:30am-sweating, hot flashes, body aches. Left knee extreme pain. Hand joints. Lethargic. Took 2 advil, improved knee and hands continued to hurt 10/6/2021 10:30am-headache, tired, body aches, left knee extreme pain 10/6/2021 11:30am-chills, shivering, left knee extreme pain, tired, slightly elevated temp 99.4, full body low grade aches. Took aleve, helped some except knee. Liniment cream. 10/6/2021 2:15pm-body aches, 99.6, chest tight, headache, tired, chills 10/6/2021 3:00 pm-left knee extreme pain. Body aches. Flushing. Chills and sweating 99.8. Took Advil 600 mg. Called doctor was informed to try Tylenol and call back at 48 hour mark 10/6/2021 6pm-more liniment cream, body aches, left knee, hand joints, nausea 10/6/2021 815pm-body aches, legs, 100.2, nausea, headache, tired but restless 10/7/2021 6:30 am-Sore body, no aches in legs, tired, slight headache, tight chest 10/7/2021 11:30 am-Left leg aching, tight chest, took walk to ease aches. Only made 1 mile slower than normal pace and sweating and heavy breathing. General feeling of being ?unwell?


VAERS ID: 1768311 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 - / SYR
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fall, Urinary incontinence
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow)

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

Write-up: Patient complained of weakness the night after receipt of Pfizer booster and seasonal influenza vaccines. Resulted in a fall and mild urinary incontinence.


VAERS ID: 1768367 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AR2183

Write-up: Patient was given one dose of Janssen COVID 19 vaccine on 10/5/2021 that had expired on 10/02/2021


VAERS ID: 1768374 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AR2184

Write-up: Patient was given one dose of Janssen COVID 19 vaccine on 10/5/2021 that had expired on 10/02/2021


VAERS ID: 1768375 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-10-05
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Delivery, Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Normal pregnancy conditions and outcomes (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: Prenatal vitamins, vitamin D 2,000. Vitamin C., vitamin B complex.
Current Illness: Breastfeeding
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Currently breastfeeding and had first period after vaginal delivery being heavier than usual, prior to vaccine the period lasted 1 day heavy, this time is going on for 3 days of heavy bleeding non-stop. Haven?t visited doctor yet.


VAERS ID: 1768386 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Headache, Immunisation, Lymphadenopathy, 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: headache with vaccine #1; extreme tiredness with vaccine #2
Other Medications: Tylenol taken after vaccine, upon being symptomatic.
Current Illness: none
Preexisting Conditions: Type 1 Diabetic
Allergies: Sulfa, Amoxicillin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Chills, febrile (101.3), headache, body aches, enlarged lymph nodes on left side.


VAERS ID: 1768392 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Hypogeusia, Parosmia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena IUD, valacyclovir, vitamin D3, Adderall XR, biotin
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: Molds, animal dander, grass, trees, environmental allergens
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Parosmia, everything smells like rotten meat. Anything savory (salty, rich) tastes of the same rotten or putrid smell. Sugary tastes remain unaffected but taste has greatly diminished. Phantosmia, or smelling things that aren?t present, is also present. The smells are always of a foul odor and are transient throughout the day. Began occurring roughly 24 hours after vaccine, remain ongoing.


VAERS ID: 1768393 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AR2185

Write-up: Patient was given one dose of Janssen COVID 19 vaccine on 10/5/2021 that had expired on 10/02/2021


VAERS ID: 1768399 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AR2186

Write-up: Patient was given one dose of Janssen COVID 19 vaccine on 10/5/2021 that had expired on 10/02/2021


VAERS ID: 1768400 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: blood pressure meds,statins,turmeric,vit d,calcium,advair diskus
Current Illness: none
Preexisting Conditions: copd
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: chills,sore arm.tiredness,body aches , headache


VAERS ID: 1768440 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CoQ10, multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Swollen lymph nodes in armpit of the arm given vaccine


VAERS ID: 1768523 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Hypertension, Hyperventilation, Tachycardia, Tremor
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Systemic: shortness of breath-Severe, Systemic: Hypertension-Severe, Systemic: Hyperventilation-Severe, Systemic: Shakiness-Severe, Systemic: Tachycardia-Severe


VAERS ID: 1768533 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Feeling hot, Full blood count, Metabolic function test, Pain, Pharyngeal hypoaesthesia, Pyrexia, Rash, Rash erythematous, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Troprol 50mg 100 mg bid Trileptal 150mg bid Aspirin 325mg as Prilosec 40mg qd
Current Illness: None
Preexisting Conditions: Fibro
Allergies: Codeine
Diagnostic Lab Data: CBC CMP
CDC Split Type:

Write-up: Shot given on 10-4. 10-5 felt achy, fever that night started vomiting. 10-6 felt hot looked in mirror red rash on neck on truck was spreading. My throat got numb went to hospital


VAERS ID: 1768534 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-10-05
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: norvasc pravachol
Current Illness: none
Preexisting Conditions: HTN, CAD, MR s/p TVMR, CVA 2014, sigmoid diverticulosis c/l LGIB s/p sigmoid artery embolization, UGIB 2/2 duodenal AVM s/p APC 2017, endometrial clear cell ca s/p TLH/ LSO and cognitive impariment
Allergies: shellfish, shrimp
Diagnostic Lab Data: COVID +
CDC Split Type:

Write-up: cough, malaise, COVID+


VAERS ID: 1768557 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / N/A RA / IM

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

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

Write-up: Wrong vaccine given. Monitored patient for additional time, no sxs reported at that time.


VAERS ID: 1768566 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-08
Onset:2021-10-05
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Lung Cancer , Htn, Diabetes , hyperlipodemia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt Presented with Chronic S.O.B And Chronic cough. Pt was treated with Asperin, Azithromycin, Cestriaxone. Pt Still hospitalized.


VAERS ID: 1768612 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 2 LA / IM

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

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash Generalized-Medium, Additional Details: Patient came into the pharmacy on 10/6/21 about 1:25pm with hives. Patient developed hives on arms and legs. First symptoms started about 30 minutes after recieving vaccine. I instructed him to take benadryl and to go to his doctor or and urgent care to get treated


VAERS ID: 1768630 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Joint injury, Limb injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1768660 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-09-29
Onset:2021-10-05
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Aphasia, Back pain, Blood test normal, Breast pain, Cardiac flutter, Chest X-ray normal, Chest pain, Costochondritis, Dysarthria, Electrocardiogram normal, Eosinophil count increased, Fibrin D dimer normal, Headache, Human chorionic gonadotropin negative, Hypertension, Lymphocyte count normal, Mean cell haemoglobin concentration normal, Muscle spasms, Nausea, Neck pain, Neutrophil count, Pain, Platelet count normal, Red cell distribution width normal, Troponin increased, White blood cell count normal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tachyarrhythmia terms, nonspecific (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Lipodystrophy (broad), Hypersensitivity (broad), 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? Yes
Hospitalized? No
Previous Vaccinations: Not sure if these are adverse but I do not react well to any vaccine. I had a flu shot in 2010 and was sick with vomiting etc fo
Other Medications: Zinc, quercetin, Chagra Mushroom and Elderberry Syrup for immune health.
Current Illness: COVID-19 in August of 2021.
Preexisting Conditions: None.
Allergies: pennicilin and latex
Diagnostic Lab Data: BP 148/74 155/84 was told this was considered high on the hospital paperwork I have. Blood work drawn Cardiac Testing Troponin result 19 ng/L Endrocrinology Beta hcg qi:Negative Diagnostic Radiology XR Chest PA and LAT 2 View: XR chest pa and lat 2 view (just reporing what I see on paperwork I dont see the word negative but she did say it was clear. Blood test cagulation for D-Dimer VTE: 0.32 mcg/ml FEU (was verbally told everything was fine nothing worrisome present) There are also several genreal chemistry tests and results that I see on all of my paperwork. It is a big list. All showing normal for lymp, nuetro absolute, eos , mchc, rdw, platelet, wbc etc..
CDC Split Type:

Write-up: On October 5th I woke up and worked ( I work from home ) and started to experience chest pain. My chest felt achy and sometimes a sharp pain (on sides of each brest) and sometimes the pain would move to top part left breast above it by chest and then it would be all over. I then felt like my heart was "lurching" and center of chest pain. I continued working and tried to just relax at home. On October 6th I woke up and it felt alot worse and was also going up my neck and back. I was just sitting working. That is when I decided to go to the ER as I was afraid I was having a heart attack or a blood clot may have been forming. When I went to the ER I had blood tests done and an EKG. They came back normal. I also had a chest xray which was clear. But, the Doctor acknowledged the chest pain and said it was chest wall inflammation Costochondritis is the term and she said it was very possible it could be from the vaccine. I was sent home after about 7 1/2 hours of being in the ER since all tests were fine but chest still hurt. Today is 10/7 and I am still having the chest pain, it is not as intense but still there it volleys from feeling dull and a bit more increased pain back down to dull again.


VAERS ID: 1768661 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache, Pain, Pain in extremity, Rhinorrhoea
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Headache , runny nose , body and left arm sore. Tylenol


VAERS ID: 1768668 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-10-05
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: First trimester pregnancy, Maternal exposure during pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)

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

Write-up: O20.9 - Vaginal bleeding in pregnancy, first trimester


VAERS ID: 1768699 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-04
Onset:2021-10-05
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin 20 mg, Loratadine 10 mg, D3 50mcg, Multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I received my second dose of the Moderna vaccine on April 4, 2021 around 10:30 a.m.
CDC Split Type:

Write-up: On the morning of 10/05/21 I woke up with a 99.8 degree fever, slight headache and occasional light cough. I went to clinic at 10:00 for a scheduled medical checkup. I notified them before going that I had these systems. When I arrived they chose to test me for Covid-19 and it came back positive. They prescribed a five day dose of Azithromycin 250mg, five day Dexamethason 6mg and tylenol as needed for fever. I also received the IV treatment of bamlanivimab and etesevimab on 10/05 at 5:20pm. My headache and fever had already went away before the treatment was given.


VAERS ID: 1768709 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SF8801 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dry mouth, Electrocardiogram, Headache, Heart rate increased, Hypertension, Pain, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Test -10/06/2021 Chest X-ray -10/06/2021 EKG - 10/06/2021
CDC Split Type: vsafe

Write-up: I experienced chest pains, pains traveling around my body, high blood pressure of 160/110, swelling and pain in my left arm, headaches, dry mouth and my heart rate was higher than usual.


VAERS ID: 1768711 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30125BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure via skin contact, Immunisation, Syringe issue
SMQs:, Medication errors (narrow)

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

Write-up: There was a syringe malfunction. When giving the vaccination, I had the needle in the patient''s arm, and went to inject the drug and the vaccine sprayed all out of the side of the syringe, therefore no drug getting into his muscle. His entire arm was wet and the patient and caregiver experienced this happen, as well. We gave the patient another dose after speaking to our vaccine specialist at Pharmacy as well as the patient and patient''s caregiver.


VAERS ID: 1768713 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Fatigue, Pain, Pruritus, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pruritic rash on face and chest. Also weakness, fatigue, and body aches. Benadryl 50mg given orally.


VAERS ID: 1768716 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Lymphadenopathy, Malaise
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: General fatigue, malaise, chills, slight fever
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: General fatigue/malaise. Swollen lymph node under arm (armpit area)


VAERS ID: 1768724 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-11
Onset:2021-10-05
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Vaccine breakthrough infection
SMQs:

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

Write-up: breakthrough case


VAERS ID: 1768730 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Chest pain. Feels like symptoms of myocarditis.


VAERS ID: 1768763 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-05
Onset:2021-10-05
   Days after vaccination:273
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Vaccine breakthrough infection
SMQs:

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

Write-up: Breakthrough case


VAERS ID: 1768780 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Autoimmune arthritis, Complement factor C3, Complement factor C4, Condition aggravated, Cytokine test, Full blood count, Human chorionic gonadotropin, Metabolic function test, Pain, Pyrexia, SARS-CoV-2 test, Total complement activity test, Tryptase
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: autoimmune arthritis
Allergies: azithromycin, cetirizine, Levaquin
Diagnostic Lab Data: cbc,cmp, bhcg, covid 19 spike domain, tryptase, ch50, c3-c9 complement, cytokine panel results pending
CDC Split Type:

Write-up: the evening of 1st round of vaccination began with joint pain, which has continued. initially had fever that has resolved at time of exam. Pt with hx autoimmune arthritis but has not had any recent flairs, and describes this pain as worse. no rash, swelling of mouth or face, difficulty breathing, or other anaphylactic symptoms.


VAERS ID: 1768808 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-02
Onset:2021-10-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fall, Injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: dizziness, syncopal episode, injury, fall.


VAERS ID: 1768823 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1922811 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Decreased appetite, Headache, Lethargy, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Vitamin D magnesium lysinopril hydrclorothiazide
Current Illness: None
Preexisting Conditions: High blood preasure
Allergies: None
Diagnostic Lab Data: No e
CDC Split Type:

Write-up: Fever pain headache loss of appetite lethargy stomach cramps


VAERS ID: 1768829 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061EZ1A / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Myalgia, Nausea, Pain, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), 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), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Body/muscle aches. Headache. Fever. Hands trembling. Body trembling. Nausea


VAERS ID: 1768832 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Loss of consciousness, Nausea, Pyrexia, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, trazafobe, osteo-biflex
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: No known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, chills, nausea, diarrhea, vomiting started at 10 am the following morning. Another 12 hours and still having above-mentioned symptoms bit also one instance of passing out


VAERS ID: 1768923 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 3 LA / IM

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

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

Write-up: None


VAERS ID: 1768926 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK - / IM

Administered by: Military       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Amphetamines negative, Angina pectoris, Angiogram cerebral normal, Arachnoid cyst, Arteriogram carotid normal, Aspartate aminotransferase normal, Barbiturates negative, Basophil percentage increased, Bilirubin urine, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood cholesterol normal, Blood creatine phosphokinase normal, Blood glucose normal, Blood magnesium normal, Blood phosphorus decreased, Blood pressure increased, Blood thyroid stimulating hormone, Blood thyroid stimulating hormone normal, Blood triglycerides decreased, Blood urine absent, Cardiac flutter, Chest X-ray abnormal, Chest pain, Computerised tomogram head abnormal, Disturbance in attention, Dizziness, Drug screen negative, Electrocardiogram normal, Eosinophil percentage increased, Full blood count normal, Glucose urine absent, Headache, Hemiparesis, Hepatic enzyme increased, High density lipoprotein increased, Hypoaesthesia, Inflammation, Interstitial lung disease, Laboratory test normal, Lipase normal, Low density lipoprotein normal, Lymphocyte percentage, Magnetic resonance imaging head abnormal, Magnetic resonance imaging head normal, Mastoid effusion, Mean cell volume normal, Mean platelet volume normal, Metabolic function test, Metabolic function test normal, Monocyte percentage, Mucosal disorder, Mucosal hypertrophy, Neurological examination abnormal, Neurological symptom, Neutrophil percentage, Nitrite urine absent, Opiates negative, Pain, Pain in extremity, Paranasal cyst, Protein total normal, Protein urine absent, Red cell distribution width normal, Scan with contrast normal, Sensory loss, Slow speech, Specific gravity urine normal, Tinnitus, Tremor, Troponin I normal, Troponin normal, Urinary sediment present, Urine abnormality, Urine analysis normal, Urine ketone body present, Urine leukocyte esterase, Urobilinogen urine decreased, Urodynamics measurement, Very low density lipoprotein decreased, White blood cells urine negative, pH urine normal
SMQs:, Liver related investigations, signs and symptoms (narrow), Dyslipidaemia (narrow), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Tachyarrhythmia terms, nonspecific (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Depression (excl suicide and self injury) (broad), Other ischaemic heart disease (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Proteinuria (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: Labs: -=---------------------------< 07 Oct 2021 $g--------------------------=- (time: 1025) Triacylglycerol Lipase = 27 Phosphate = 2.9 Troponin I Cardiac = <0.01 CMP 144 : 107 : 11 AG {?} Ca 9.1 AST 33 -------+-------+-------< 109 Prot 7.0 ALT 58 4.1 : 28 : 1.0 Alb 4.1 AP 56 Bili 0.4 LIPID PANEL Triglyceride = 31 LDL Cholesterol = 54 VLDL Cholesterol = 6 Cholesterol = 118 Cholesterol/HDL Cholesterol = 2.0 HDL Cholesterol = 58 CBC %N 65.5 / 14.6 / MCV 85.6 %E 2.2 5.50 $g----< 242 RDW 13.2 %B 0.9 / 42.1 / MPV 9.4 %M {?} %L 23.6 (time: 0944) Glucose = 114 -=---------------------------< 06 Oct 2021 $g--------------------------=- (time: 0150) DRUG SCREEN URINE Methylenedioxymethamphetamine = NONE DETECTED Oxycodone = NONE DETECTED Propoxyphene = NONE DETECTED Amphetamines = NONE DETECTED Barbiturates = NONE DETECTED Benzodiazepines = NONE DETECTED Cocaine = NONE DETECTED Opiates = NONE DETECTED Phencyclidine = NONE DETECTED Cannabinoids = NONE DETECTED Methadone Confirm = NONE DETECTED URINALYSIS Color = Yellow Clarity = Clear Specific Gravity = 1.024 Protein = Negative Glucose = NEGATIVE Ketones = 5 mg/dl Bilirubin = NEGATIVE Blood = Negative Nitrite = NEGATIVE Urobilinogen = Normal Leukocyte Esterase = NEGATIVE Epithelial Cells Squamous = <1/HPF Mucus = FEW pH = 6.0 WBC = <1 -=---------------------------< 05 Oct 2021 $g--------------------------=- (time: 2258) Glucose = 105 (time: 2350) Magnesium = 2.2 Phosphate = 4.2 Troponin I Cardiac = <0.01 Thyrotropin = 4.01 Creatine Kinase = 149 CMP 143 : 108 : 15 AG {?} Ca 9.1 AST 35 -------+-------+-------< 105 Prot 6.6 ALT 63 4.2 : 28 : 1.1 Alb 4.1 AP 44 Bili 0.4 CBC %N 65.0 / 14.0 / MCV 86.3 %E 2.6 7.29 $g----< 230 RDW 13.4 %B 0.7 / 41.0 / MPV 9.7 %M {?} %L 24.3 Rads: **********MRI, BRAIN (W/O CONTRAST)********** Status: Complete Procedure: MRI, BRAIN (W/O CONTRAST) Order Date: 07-Oct-2021 12:49:00 Order Comment: ED-16 Reason for Order: L face tingling, Hx L arm tingling Exam Date/Time: 07-Oct-2021 13:19:00 Transcription Date/Time: 07-Oct-2021 13:57:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 07-Oct-2021 13:52:00 Report Text: Brain MRI without gadolinium History: Left face tingling in left arm tingling. Technique: MRI of the brain was performed utilizing the following sequences: Sagittal 3-D T1 with MPRs, axial DWI, axial T2 FLAIR, axial T1, axial SWI, sagittal 3-D T2 FLAIR and axial T2 FINDINGS: Acute: No hemorrhage, herniation, or hydrocephalus. No evidence of recent infarct. Brain: Incidental note of mega cisterna magna or arachnoid cyst in the posterior fossa. No evidence of vermian hypoplasia. Otherwise, brain parenchyma is within normal limits in signal and volume for age. Vessels: No abnormal intravascular signal to suggest thrombosis. Bones: No suspicious lesion in the calvarium or skull base. Other: Diffuse paranasal sinus mucosal disease. IMPRESSION: No acute intracranial findings. **********CT, HEAD/BRAIN ANGIOGRAM (W/CONTRAST) (PG)********** Status: Complete Procedure: CT, HEAD/BRAIN ANGIOGRAM (W/CONTRAST) (PG) Order Date: 05-Oct-2021 23:30:00 Order Comment: ED-22 Reason for Order: ABNORMAL PARAESTHESIAS NOT FITTING IN TYPICAL ANATOMIC DISTRUBUTION Exam Date/Time: 06-Oct-2021 00:45:00 Transcription Date/Time: 06-Oct-2021 01:25:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 06-Oct-2021 01:25:00 Report Text: APPROVED DATE/TIME: 06 Oct 2021@0024 REASON: ABNORMAL PARAESTHESIAS NOT FITTING IN TYPICAL ANATOMIC DISTRUBUTION CONTRAST - TYPE: ISOVUE 370 VOLUME: 60ml STUDY CODE: CODE 1000 NO ALERT REQUIRED PROCEDURE: CT, HEAD/BRAIN ANGIOGRAM (W/CONT CT angiogram head and neck. Axial data was acquired from the aortic arch to the vertex during dynamic arterial phase contrast administration. Multiplanar reformatted images were obtained on an independent 3-D workstation. Calculation of stenoses was obtain utilizing NASCET criteria. Dose reduction techniques were utilized. Priors: CT head of same date. Findings: Aortic arch is normal in caliber. The origin of the innominate artery, left common carotid artery and left subclavian arteries are patent. Right common and right subclavian artery origins are patent. The bilateral vertebral artery origins are patent. Left carotid: There is no atherosclerotic disease or stenosis. Right carotid: There is no atherosclerotic disease or stenosis. Vertebral arteries: There is no evidence of focal stenosis or occlusion. There is no evidence of dissection. Anterior circulation: The internal carotid arteries are present at the skull base. The supraclinoid internal carotid arteries, anterior and middle cerebral arteries are patent without evidence of focal stenosis or occlusion. Posterior circulation: The distal vertebral arteries, basilar artery and proximal posterior cerebral arteries and superior cerebellar arteries are patent. There is no evidence of focal stenosis or occlusion. There is no evidence of aneurysm or vascular malformation. Dural venous sinuses are patent. Impression: No evidence of significant stenosis, occlusion or vascular malformation. Attention Patients / Service-members: If you have questions or concerns about the results in this report, Please contact your ordering provider or primary care team. **********CT, NECK ANGIOGRAM (W/CONTRAST) (PG)********** Status: Complete Procedure: CT, NECK ANGIOGRAM (W/CONTRAST) (PG) Order Date: 05-Oct-2021 23:31:00 Order Comment: ED-22 Reason for Order: Abnormal paresthesias not fitting in typical anatomic distrubution Exam Date/Time: 06-Oct-2021 00:45:00 Transcription Date/Time: 06-Oct-2021 01:26:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 06-Oct-2021 01:26:00 Report Text: APPROVED DATE/TIME: 06 Oct 2021@0024 REASON: Abnormal paresthesias not fitting in typical anatomic distrubution CONTRAST - TYPE: ISOVUE 370 VOLUME: 60ml STUDY CODE: CODE 1000 NO ALERT REQUIRED PROCEDURE: CT, NECK ANGIOGRAM (W/CONTRAST) CT angiogram head and neck. Axial data was acquired from the aortic arch to the vertex during dynamic arterial phase contrast administration. Multiplanar reformatted images were obtained on an independent 3-D workstation. Calculation of stenoses was obtain utilizing NASCET criteria. Dose reduction techniques were utilized. Priors: CT head of same date. Findings: Aortic arch is normal in caliber. The origin of the innominate artery, left common carotid artery and left subclavian arteries are patent. Right common and right subclavian artery origins are patent. The bilateral vertebral artery origins are patent. Left carotid: There is no atherosclerotic disease or stenosis. Right carotid: There is no atherosclerotic disease or stenosis. Vertebral arteries: There is no evidence of focal stenosis or occlusion. There is no evidence of dissection. Anterior circulation: The internal carotid arteries are present at the skull base. The supraclinoid internal carotid arteries, anterior and middle cerebral arteries are patent without evidence of focal stenosis or occlusion. Posterior circulation: The distal vertebral arteries, basilar artery and proximal posterior cerebral arteries and superior cerebellar arteries are patent. There is no evidence of focal stenosis or occlusion. There is no evidence of aneurysm or vascular malformation. Dural venous sinuses are patent. Impression: No evidence of significant stenosis, occlusion or vascular malformation. Attention Patients / Service-members: If you have questions or concerns about the results in this report, Please contact your ordering provider or primary care team. **********CT, HEAD/BRAIN (W/O CONTRAST)********** Status: Complete Procedure: CT, HEAD/BRAIN (W/O CONTRAST) Order Date: 05-Oct-2021 23:32:00 Order Comment: ED-22 Reason for Order: Abnormal paresthesias not fitting in typical anatomic distrubution Exam Date/Time: 06-Oct-2021 00:45:00 Transcription Date/Time: 06-Oct-2021 01:22:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 06-Oct-2021 01:22:00 Report Text: APPROVED DATE/TIME: 06 Oct 2021@0020 REASON: Abnormal paresthesias not fitting in typical anatomic distrubution STUDY CODE: CODE 1000 NO ALERT REQUIRED PROCEDURE: CT, HEAD/BRAIN (W/O CONTRAST) Technique: CT scan of the brain was obtained from skull base to vertex without contrast. Dose reduction techniques were utilized. Comparison: None. Findings: The ventricles and sulci are normal. There is a prominent cisterna magna. There is no cerebral or cerebellar edema. There is no evidence of intracranial hemorrhage or mass-effect. No extra-axial fluid collections are identified. Skull base and calvarium are intact. There is a prior right-sided canal wall up mastoidectomy. There is rounded soft tissue within the right mastoid bowl measuring 7 mm. There is fluid within the left mastoid cavity. There are bilateral maxillary sinus retention cysts. There is mild ethmoid sinus mucosal thickening. There is chronic appearing inflammatory debris right sphenoid sinus. There is near complete opacification of the right frontal sinus. Impression: No evidence of acute hemorrhage, edema or mass-effect. Additional findings, as above. Attention Patients / Service-members: If you have questions or concerns about the results in this report, Please contact your ordering provider or primary care team. **********PORT CHEST********** Status: Complete Procedure: PORT CHEST Order Date: 07-Oct-2021 10:35:00 Order Comment: ED-16 Reason for Order: CHEST PAIN Exam Date/Time: 07-Oct-2021 10:36:00 Transcription Date/Time: 07-Oct-2021 10:52:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 07-Oct-2021 10:46:00 Report Text: TECHNIQUE: Portable AP chest radiograph. COMPARISON: None available. FINDINGS: Tubes and lines: None. Lungs: The lungs are adequately inflated. Mildly prominent reticular interstitial lung markings. Pleura: There is no pneumothorax. There is no pleural effusion. Heart and mediastinum: Unremarkable. Bones/soft tissues: Unremarkable.. IMPRESSION: Nonspecific mildly increased reticular interstitial lung markings. This may be artifactual secondary to technique however, underlying viral infection is not entirely excluded. EKG: NSR, no STEMI. No ischemic changes noted.
CDC Split Type:

Write-up: Patient reports onset of symptoms after first vaccine 07SEP. Kept a log of symptoms in his phone. Notes that he was forced to receive vaccine. Recorded sx to include: "ear ringing, hearing loss, dizziness, mood fatigue, fatigue, sometimes sounds funny". 18Sep recorded "heart flutters while running, off balance, front of brain fuzzy, memory loss." 05OCT received second vaccination, recorded "Ringing in ear again, headache, front of brain feels numb, hard to focus, wife dropped off at hospital, heart flutters 1-2 min, show speaking, lost some feeling on left side of body, tremble shaking." Patient was evaluated at that time w/ CBC, CMP, CK, TSH, troponin, phos, mag, UA, UDS. CT head, CTA head, CTA neck performed w/o any abnormalities. All labs were WNL besides mildly elevated liver enzymes. EKG w/o any remarkable findings. Patient instructed to f/u with his PA. Had an appt with his PA this AM - afterwards noted "0915 numbness on L side of face, dull pain L chest, shot down arm (lasted 1 minute), subsided on its own. While in the waiting room had heartaches." Presented a second time to the ED. Upon further clarification - pt describes chest pain sx as a dull feeling in his L chest w/o associated nausea, diaphoresis, SOB or difficulty breathing. Lasted less that 1 min, not exertional. Describes numbness as "like goosebumps or when your foot goes numb." Currently has a headache, now 4-5/10 located at the center of his forehead. Has not taken any pain medications for this. No fevers/chills, nausea/vomiting, no weight loss or BM changes, no SOB, no abdominal pain. Feels like he''s had "slight inflammation" - has seasonal allergies. Felt lightheaded a few times while standing up quickly from a squat or sitting, no syncope/presyncope, no rashes/sores, no weakness. Neuro exam: CN2-12 intact. Does note decreased sensation (50%) in L side of face in opthalmic, maxillary, and mandibular distributions of trigeminal nerve. Motor fxn of trigeminal nerve is symmetric. Strength symmetric in face and bilateral upper and lower extremities. Sensation decreased in LUE and LLE (50%) compared to right. Normal gait. No cerebellar signs. Patient is a 45 y/o M w/ left-sided weakness and numbness after COVID vaccine 2 days ago, endorsing similar sx after first dose in early September. Presented initally 05OCT, CT head, CTA head, CTA neck nml. Symptoms concerning for stroke vs. TIA vs. brain lesion. ABCD2 score of 3 (elevated BP, long duration of numbness), low risk of stroke. NIHSS of 1. Patient has had many brief, transient symptoms since receiving first dose of Pfizer vaccine. Symptoms appear to vary in terms of character, temporality, and severity. CT head, CTA head, CTA neck, MRI head were performed, no e/o vascular injury, infarction, or stenosis. No brain lesions or inflammatory changes. Patient w/ unremarkable labs and otherwise healthy. Does have unilateral decrease in sensation in left face, arm, and leg on exam which are not readily explained given imaging and otherwise unremarkable exam. Chest pain not consistent with angina, normal EKG and troponins negative. With very low likelihood of ischemic event, patient can discharge home w/ f/u with his PA (has an appt this Tuesday). Neurology consult was placed to further evaluate decreased sensation in left face and left arm/leg.


VAERS ID: 1768929 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 3 LA / IM

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

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


VAERS ID: 1769005 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Injection site erythema, Injection site warmth, Lymphadenopathy, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), 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), Hypoglycaemia (broad)

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

Write-up: Fever, chills, severely swollen arm, redness and heat and injection site, swollen lymp nodes, headache, sweating All lasting more than 3 days


VAERS ID: 1769033 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allergy test, Hypersensitivity, Pharyngeal swelling, Rash, Swelling face, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (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: As per Pharmacy - to use Over the counter Baby Aspirin 81 grams
Current Illness: Currently treating : Ovarian cyst , Unknown large Cystial Mass, Bilateral carpal tunnel syndrome, Posterior Tibal tendinitis, Right Lower Extremity Plantar Fasciitis, & Baker?s Cyst behind Right Knee.
Preexisting Conditions: Long term illnesses: Kidney stones Calcium stones Protein stones And Vitamin C stones
Allergies: None
Diagnostic Lab Data: Steroid Intramuscular injection left arm, ordered a 6K allergy panel with immunology. Prescribed 20mg of Famotidine every 12 hours, 4mg of Methylpredinsolone use as directed for 5 days & Over the Counter Benadryl twice a day.
CDC Split Type:

Write-up: Allergic reaction: wheezing, presented with wheezing rash & swelling of throat/face (lips, cheeks, eye lids, ears, neck)


VAERS ID: 1769088 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-03
Onset:2021-10-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Lymphadenopathy, Musculoskeletal pain, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega-3, magnesium, Areds2, Estradiol,Triamterene-hydroochlorothiazide,Losartan,Clobetasol
Current Illness:
Preexisting Conditions: Hypertension, pre-diabetic, overweight
Allergies: Macrobid
Diagnostic Lab Data: Ultrasound of shoulder blade 10/5/2021 CT scan same area 10/5/2021 They said there were a cluster of swollen lymph nodes and determined the cause was the booster shot.
CDC Split Type:

Write-up: On October 5th around noon noticed shoulder-blade area was sore. About a 1/2 hour later the area was swollen and tender. Sent a message to my dr. By the time they got back with me they didn?t have any openings so they sent me to urgent care. That dr didn?t know what was causing it, said it felt like fluid under my skin. I told him that I had had the booster shot on the same side two days before but he did not think it was connected. He advised me to go to the emergency room. I went to the emergency room.Dr there did ultrasound of area said it looked like fluid around the lymph node. She then had them do a CT scan.


VAERS ID: 1769268 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

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

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

Write-up: The vaccine was given after the post-expiration date?no adverse reaction.


VAERS ID: 1769274 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular 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: Albuterol inhaler, PRN, Dupixent, and iron supplements.
Current Illness: Unknown
Preexisting Conditions: Asthma, anemia, exzema.
Allergies: Anaphylaxis to fish and beef. Tongue tingling with cow milk and eggs.
Diagnostic Lab Data:
CDC Split Type:

Write-up: The client reported feeling a "dull headache, dizziness, and lightheaded" to RN and EMT at 5:07PM. The client rated the headache pain at a 5 on a 10 point scale. The client denied any other s/s of anaphylaxis. Vitals obtained at 5:07PM were as follows: automatic BP 156/99, HR 78, O2 95%. The client stated she had eaten an egg and juice for breakfast, and a piece of pumpkin bread on her way to the vaccination site. The client drover herself to the vaccination site today. The client has a history of asthma controlled with an Albuterol inhaler for as needed, anemia controlled with iron supplements, and exzema controlled with Dupixent. RN responded to the client for additional assistance. Repeat vitals obtained at 5:14PM were as follows: automatic BP 161/98, O2 97%, and HR 82. The client reported a "mild little headache." RN inquired if the client was still feeling dizzy and the client replied, "It''s okay." RN provided education regarding s/s of anaphylaxis and when to seek EMS. The client voiced understanding of this education. Repeat vitals obtained at 5:17PM were as follows: manual BP 148/98, HR 75, O2 96%. The client showed RN and RN a "red and itchy" spot on the front of her neck. The client described the spot as exzema and stated it had been present for 2-3 days. Repeat vitals obtained at 5:25PM were as follows: manual BP 148/86, HR 76, O2 95%. The client stated her headache was "okay" and rated the pain at a 5 on a 10 point scale. The client stated, "I feel like I can walk. I feel like I can drive okay." RN provided education regarding the client''s blood pressure and recommended the client follow up with her primary care doctor regarding her blood pressure. The client voiced understanding of this education. Repeat vitals obtained at 5:32 PM were as follows: manual BP 150/86, HR 73, O2 99%. The client stated, "I feel okay, a little tiny headache." The client rated the headache at a 4-5 on a 10 point scale. The client denied any other s/s of anaphylaxis. Repeat vitals obtained at 5:40 PM were as follows: manual BP 150/86, HR 75, O2 97%. The client stood up unassisted and ambulated unassisted with a steady gait out of the vaccination site.


VAERS ID: 1769279 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

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

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

Write-up: The vaccine was given after the post-expiration date?no adverse reaction.


VAERS ID: 1769287 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

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

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

Write-up: The vaccine was given post-expiration date with no adverse reaction.


VAERS ID: 1769289 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

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

Write-up: At 8pm the evening of the vaccination, patient felt tired and achy. The next morning she felt flushed. Later on in the evening, the patient noticed that she had a swollen lymph node in her one of her armpits.


VAERS ID: 1769291 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

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

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

Write-up: The vaccine was given post-expiration date. no adverse reaction


VAERS ID: 1769682 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Covid pneumonia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up 10/5 with body aches, fever, sore arm and headache


VAERS ID: 1769699 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Impaired work ability, Lymph node pain, 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: Oral contraceptives Sertraline
Current Illness: None
Preexisting Conditions: None
Allergies: Codine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severely enlarged lymph nodes at clavicle, neck, and axillary. Unable to wear clothing due to tenderness in enlarged lymph nodes, unable to work at hospital x2 days. Lymphatic drainage massage did not resolve. Swollen nodes very painful.


VAERS ID: 1769861 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Nausea Headache Muscle pain Joint pain Chills Fatigue


VAERS ID: 1769863 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site erythema, Injection site pain, Injection site swelling, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Tiredness Headache Muscle pain Chills Fever Injection arm : Pain Redness Swelling Treatmemt: Took 2 pills of motrin Took 2 gelcaps tylenol Outcome: Recovered


VAERS ID: 1770005 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: None
Preexisting Conditions: Asthma and migraines
Allergies: Latex Tree nuts Peanuts Nickel Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, throwing up, body aches, migraine, diarrhea, nausea


VAERS ID: 1770022 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-10-01
Onset:2021-10-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Pain in extremity, Vaccine positive rechallenge
SMQs:, 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: Same event age 52 at 2nd dose in March 2021.
Other Medications: Losartan, Prilosec, Vitamin D
Current Illness: Severe anemia, Feraheme infusions
Preexisting Conditions: Feraheme infusions, severe anemia, hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe pain on underside of arm and underarm/armpit area.


VAERS ID: 1770028 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / UN

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: Lantus and Novalog, Albuterol, Flovent, Magnesium, Multiple Vitamins
Current Illness:
Preexisting Conditions: Diabetes, Asthma
Allergies: Penicillin, codeine, NSaids, Sulfa containing drugs, Actos, Fruits and Tree nuts Lotions with fruits and tree nuts, and eucerin
Diagnostic Lab Data: I have not had any done, will call my own doctor in the morning after work, instructed to do so by the health Covid clinic people.
CDC Split Type:

Write-up: I work nights, had the Covid-19 Booster shot at that morning 10/05/2021, immediately after work, then went home to sleep. When I awoke in the afternoon, my left arm site was swollen with a large bump, quite red, sore, and very itchy. So I used an anti itch cream, and ice, Went to work that night, and used a hot pack, and then ice again. Plus Tylenol Today, 10/08/2021, a coworker said it looked larger and redder than it had Tuesday night


VAERS ID: 1770414 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-10-05
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211005; Test Name: Antibody test; Result Unstructured Data: Negative, No antibodies.
CDC Split Type: USJNJFOC20211011984

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned an 87 year old White and Non Hispanic or Latino female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029 and expiry: UNKNOWN) 1 total, dose was not reported, administered at right arm on 17-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. Patient needed a blood test after she was vaccinated and patient asked the doctor to check for antibodies against covid-19. On 05-OCT-2021, it was reported that patient had less than 1 %, that means patient had no antibodies (Confirmed immunological vaccine failure). Laboratory data (dates unspecified) included: Antibody test (NR: not provided) Negative, Less than 1% (No antibodies). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000196260.; Sender''s Comments: V0:20211011984-covid-19 vaccine ad26.cov2.s-confirmed immunological vaccine failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1771137 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-28
Onset:2021-10-05
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Rash, Rash pruritic, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer/BioNTech
Other Medications: generic for Zoloft estradiol multi vitamin emergency c gummies Zyrtec
Current Illness: none
Preexisting Conditions: none
Allergies: morphine, Demerol, codeine, Zithromax, blueberries
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Rash that appears at different spots on body and last approximate 1-2 days itchy, bumps and sometimes whelps. Taking Benadryl to help with the discomfort and itchiness Rash started approx 1 week after vaccine was administered on 9/5/21 and 9/28/21


VAERS ID: 1771142 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site pain, Pain in extremity
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Systemic: Sore Arm for 1 day as per mom and pt has taken ibuprofen for 24 hours.-Mild, Error: Patient Too Young for Vaccine Administered-, Additional Details: Sore Arm for 1 day as per mom and pt has taken ibuprofen for 24 hours. Pharmacist has requested the immunization team to contact the patients family regarding any further notice. patient has been waiting for the call from pharmacy in order to hear anything in details. The error could have been prevented if laptops were present during the clinic and woking. we could not type a prescription as system was automatically rejecting due to age limit.


VAERS ID: 1771143 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site pain, Pain in extremity, Product administered to patient of inappropriate age
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Sore arm for 24 hours and patient has been given ibuprofen for pain-Mild, Error: Patient Too Young for Vaccine Administered-, Additional Details: Pharmacist contacted patients family regarding the wrong administration event. Mom wanted to talk to CVS legal immunization team regarding the event and also wanted to inform her employer as well. the error could have been prevented if we have working laptops at the clinic site. patient has been requested not to get the second dose of vaccine untill further notice.


VAERS ID: 1771181 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Bruising at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium


VAERS ID: 1771197 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Shoulder injury related to vaccine administration
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: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1771395 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 2 LA / IM

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

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

Write-up: Itchy rash along arm


VAERS ID: 1771432 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt did not tell us
Current Illness: Pt did not tell us
Preexisting Conditions: Pt did not tell us
Allergies: Pt said none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt came to or clinic and said he wanted a Janssen shot. He did not tell us that he had already gotten the Pfizer shot on 4/1/21 and 4/24/21 -- when we processed the shot thru his insurance. it told us to use the same manufacturer as before . That''s when we questioned him about the other covid shots he got which was not revealed to us before. He said technically he did not get any shots since it was more than 6 months ago. He then started to say he has an underlying condtion and needed this shot. We told him he could have gotten the Pfizer shot in that case but it seems he came specially to get the Janssen shot and also said it was approved elsewhere.


VAERS ID: 1771442 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Diarrhoea, Dyspnoea, Fatigue, Imaging procedure, Laboratory test, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol, Norvasc, Vitamin D3, Melatonin, Omeprazole
Current Illness: Constipation, deconditioning
Preexisting Conditions: HTN, Cardiomyopathy, GERD, Osteoporosis, DM,. IBS
Allergies: Sulfa, Codeine, Gluten, Whey, Lactose
Diagnostic Lab Data: Imaging 10/6, Labs 10/7
CDC Split Type:

Write-up: Fatigue, Myalgia, Shortness of Breath, Fever, Diarrhea


VAERS ID: 1771448 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Eye swelling, Peripheral swelling, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, d3+k2, loratadine 10mg, preservision areds (eyes).
Current Illness: None
Preexisting Conditions: None
Allergies: None, but a bee sting on my finger about a week and a half before I did get a reaction to, but that also did not become life threatening.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The worst started four hours after the vaccine and lasted ten hours, then I slept awhile, and the next day it was still effecting me but to a lesser degree and by the following day no symptoms. My first dose knocked me out for three days (chills, tired, headaches) the second dose was four days of the same. This booster although over much quicker, it''s was a little scary, and touch and go that first night not knowing if my breathing was going to be effected since it was my arm was swollen, and felt it in my neck and in my eye on that side. I feel it''s important to be vaccinated being in healthcare, but I''m concerned about the next one. Perhaps an alternative vaccine, or something I can do on my end, or think about retirement.


VAERS ID: 1771503 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Insomnia, Mobility decreased
SMQs:, Parkinson-like events (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: Trintellix (antidepressant) Vyvance (amphetamine)
Current Illness: none
Preexisting Conditions: depression, treated with above medications
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Roughly three hours post-injection, I began experiencing severe intramuscular pain at the injection site (similar in intensity to the feeling of a dislocated shoulder or a fractured bone), which for the next 12 hours was so unremitting and extreme, I was unable to sleep. After 12 hours, while the intensity of the pain remained the same, it only occurred when I engaged the muscle of that arm, so that for the next two days, if I needed to use my left hand at all, I used my right arm to lift it. It has now been three days since the vaccination. And though I can lift my left arm now without assistance, it still hurts to do so, though significantly less than it had initially.


VAERS ID: 1771517 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-03-04
Onset:2021-10-05
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiac telemetry abnormal, Cough, Dizziness, Headache, Hiccups, Hyperhidrosis, Malaise, Nausea, Pain, Presyncope, SARS-CoV-2 test positive, Tachycardia, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chief Complaint pt in ENDO to get MAB- sudden onset of not feeling well, diaphoretic and almost passed out per endo staff. Denies pain or any other symptoms. hx of chronic afib- per ENDO pt had a run of 16 PVC''s while on monitor History of Present Illness Very pleasant 69-year-old gentleman presents to the emergency room upon referral from outpatient infusion. He became ill with some body aches headache cough and hiccups starting on Monday. He got tested for and was diagnosed with Covid on Wednesday at orchard drug, and had been referred to get monoclonal antibody infusion. As he was preparing for that, he was being monitored on telemetry and was noted to have some nausea and lightheadedness that corresponded with 16 beats of a wide-complex tachycardia. He was mildly symptomatic with this, it self resolved. Because of this the process stopped and he was referred to the emergency room for further evaluation. I have been informed that Dr, has seen him and recommended admission for observation close monitoring. He does have a history of paroxysmal atrial fibrillation and follows with electrophysiology Dr.. With known recent diagnosis of Covid on Wednesday, administering Regeneron here today Not repeating test today


VAERS ID: 1771550 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-28
Onset:2021-10-05
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Headache, Nausea, Pyrexia, Rhinorrhoea, Swelling face
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Previous Vaccinations:
Other Medications: STEROIDS FOR SWELLEN PHENTERMINE
Current Illness: no
Preexisting Conditions: no
Allergies: penicillin
Diagnostic Lab Data: went to the ER on 10/07/2021 and was given steroids
CDC Split Type:

Write-up: Patient reported that she having normal symptoms of nausea, headache, and chills no fever... on October she woke with a cough, swollen face, and a fever with running nose


VAERS ID: 1771635 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Chest pain, centralized, worse at night. History of sports asthma, no attack in years.


VAERS ID: 1771642 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, 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: Blood pressure medication and adderall
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headaches and swollen lymph nodes.


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