National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/10/2021 release of VAERS data:

Found 686,636 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 358 out of 6,867

Result pages: prev   259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457   next


VAERS ID: 1479432 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-06
Onset:2021-07-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nasopharyngitis, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion, sertraline, norgestimate/ethinyl estradiol (birth control), vitamin D, iron supplement, daily mulivitamin
Current Illness:
Preexisting Conditions:
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hours after receiving the vaccine I felt as though I had a headcold with the severity of my symptoms decreasing day-by-day for about eight days. The ninth day, after my "headcold" symptoms had abated; I started finding itchy hives first on my left arm, the left side of my back, and the left side of my upper stomach. The next day the hives has spread to my scalp, face, ears, left hand, groin, left leg, the upper parts of both my right arm and right leg, the right side of my back, and most of my torso.


VAERS ID: 1479616 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-12
Onset:2021-07-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abdomen abnormal, Haemoglobin decreased, Intensive care, Platelet count decreased, Syncope, Thrombocytopenia
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Iron supplementation
Current Illness: none known
Preexisting Conditions: iron deficiency anemia, dysfunctional uterine bleeding
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented after syncopal episode and abdominal pain, was found to have profound thrombocytopenia. CT abdomen was done which was concerning for ruptured ovarian cyst. Hgb dropped to 5.8, plts at time of report were 13. Patient transferred to the ICU for further management


VAERS ID: 1479999 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-03-30
Onset:2021-07-15
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: tested positive for COVID on 07/15/21
CDC Split Type:

Write-up: Patient sent tested positive for COVID on 07/15 when fully vaccinated. he did not have any symptoms


VAERS ID: 1481302 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Compulsions, Confusional state, Dizziness, Eye movement disorder, Flushing, Heart rate increased, Hyperhidrosis, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Tachycardia-Severe, Additional Details: pt was very complusive and her eyes rolled back. Started sweating, pulse rate going up, light headed


VAERS ID: 1481303 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 3 RA / IM

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

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

Write-up: Error: Booster Given Too Early-


VAERS ID: 1481307 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-07-15
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A2LA / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Joint swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic reaction to bee sting
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210715; Test Name: Blood pressure; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210733586

Write-up: SWELLING IN BOTH ANKLES; SWELLING IN FEET; This spontaneous report received from a patient concerned a 66 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included bee string allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A2LA, and batch number: 042A2LA expiry: UNKNOWN) dose was not reported, administered on 15-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 15-JUL-2021, the subject experienced swelling in both ankles. On 15-JUL-2021, the subject experienced swelling in feet. Laboratory data included: Blood pressure (NR: not provided) Normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from swelling in both ankles, and swelling in feet. This report was non-serious.


VAERS ID: 1481309 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-07-15
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210733692

Write-up: SYRINGE WAS KEPT AT ROOM TEMPERATURE FOR THREE HOURS AND ADMINISTERED TODAY; POOR QUALITY VACCINE ADMINISTERED; This spontaneous report received from a physician concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 15-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 15-JUL-2021, the subject experienced syringe was kept at room temperature for three hours and administered today. On 15-JUL-2021, the subject experienced poor quality vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the syringe was kept at room temperature for three hours and administered today and poor quality vaccine administered was not reported. This report was non-serious.


VAERS ID: 1481315 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Dizziness, Dyspnoea, Flushing, Hyperhidrosis, Loss of consciousness, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Shakiness-Mild, Systemic: Weakness-Mild, Additional Details: Patient passed out for a few moments but was responsive very quickly. Paramedics came and took her to the ER


VAERS ID: 1481339 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 LA / IM

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

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

Write-up: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Severe, Systemic: Vomiting-Severe, Systemic: Weakness-Severe, Additional Details: Patient reports she was diagnosed as having a vasovagal syncope to the pfizer covid vaccine at the ER


VAERS ID: 1481349 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Incorrect dosage administered, No adverse event, Product preparation 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: treated with HCTZ x 4 months and hypercholesterolemia treated with atorvastatin and ezetimibe.
Current Illness: N/A
Preexisting Conditions: hypertension
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received .3ml undiluted vaccine. After 24hr follow up no adverse sx


VAERS ID: 1481406 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 10 mg daily prn, last taken 1 day prior to vaccine
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Troponin July 15-16, Peak of 3.38
CDC Split Type:

Write-up: myopericarditis


VAERS ID: 1481411 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Headache, Influenza like illness, Myalgia, Pain in extremity, Pyrexia, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Montelukast, Albuterol Sulfate HFA Inhaler & Liquid Solution for Nebulizer, Allegra, Motrin, Tylenol, Aspirin, Multi Vitamin
Current Illness: Pneumonia Left Lower Lobe Diagnosed 6/19 Cleared 7/11
Preexisting Conditions: Arthritis, Bronchitis, Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: on 7/15 10 min. after getting shot started coughing & wheezing used inhaler, water & cough drops 6-7 min later felt okay. on 7/16 Woke up with headache & arm was sore. around 1-1:30 pm began to have flu like symptoms coughing, chills, muscle aches, fever 102. Took Motrin, Tylenol, used Inhaler, went to bed around 7pm fever went down.


VAERS ID: 1481430 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling hot, Headache, Joint warmth, Nausea, Pain, Rash erythematous, Rash papular, Skin warm
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: large red rash warm to the touch, swellen, started witin 24hours of the vaccine and still has red swollen rash sat 7/17/21 day of report. also mentioned she had body aches, chills, warm ankles and feet, nausea, headache for about 24 hours. I recommended she contact her primarty provider, start taking benedryl for several days.


VAERS ID: 1481434 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Axillary pain, Chest X-ray, Dizziness, Fatigue, Feeling abnormal, Headache, Injection site pain, Injection site pruritus, Injection site reaction, Injection site warmth, Lymphadenopathy, Nausea, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal clelexa Zyrtec
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: Went to patient first after speaking with call line nurse on 07/16/2021. Chest x-ray completed waiting on findings if any. Was referred to hematologist and told to just take over the counter pain meds.
CDC Split Type:

Write-up: First day 07/09/2021- nothing Second day 07/10/2021- massive injection site pain headache nausea dizzy fatigue Third day 07/11/2021- little fatigue mild headache 07/12 - 07/14/2021 weakness after mild activity sixth day 07/15/2021- woke up with pain under armpit left side walnut sized lymph node under armpit hurts to even rest arm down seventh day 07/16/2021 - still have pain in armpit on left side with walnut size lymph node on left side still, with itching at injection site and hot to touch. Also have painful swollen lymph nodes on right side of neck in left shoulder blade and in armpit on right side. eighth day 07/17/2021- injection site now has a red rash is hot to touch and itchy. Still have swollen lymph nodes in both armpits one in right side of upper neck, near left collar bone and in left shoulder blade. Feeling miserable.


VAERS ID: 1481484 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Chest discomfort, Chills, Dry mouth, Electrocardiogram, Feeling hot, Gait inability, Headache, Hyperventilation, Incoherent, Nausea, Speech disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations: Flu shot
Other Medications: Lisinopril Metformin Atrovastatin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: E k g blood pressure sugar test breathing test
CDC Split Type:

Write-up: Incoherent dry mouth nausea headaches speech impaired could not walk chills hothead hyperventilating and chest pressure


VAERS ID: 1481492 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1481494 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0178 / 2 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1481497 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0178 / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1481499 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1481500 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1481544 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Feeding disorder, Lymphadenopathy, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Tongue started swelling about 7 hours after injection; swelling worsened after biting it; unable to eat, take medication and have trouble breathing when lying down. Presented to hospital 07/17 with lymphadenopathy and enlarged tongue; VSS. Treatments included epinephrine IM, solu-medrol IV; Benadryl IV; and famotidine IV


VAERS ID: 1481554 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal multivitamin. naturals algae dha omega 3. restorative probiotic.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen, raised area about 3" around vaccine site, very itchy.


VAERS ID: 1481575 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia
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: Sertraline.
Current Illness: No
Preexisting Conditions: No
Allergies: Gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: Loss of taste.


VAERS ID: 1481631 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20382V8 / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Chai Hu Hui Zhi Tang (Chinese medicine with Bupleurum and Cinnamon Combination)
Current Illness: None.
Preexisting Conditions: None.
Allergies: None known.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Hives appeared suddenly on left leg around ankle. They have continued to appear on the left leg, both upper and lower leg for around 3 days. Most recently the right leg has hives appearing.


VAERS ID: 1481634 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Headache, Illness
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estratest, effexor, zolpidem, ritalin, tizanadine, multi vits
Current Illness: none
Preexisting Conditions: Fibro/CFS/depression, arthritis
Allergies: Sulfa, tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: On the second day, I got a headache, along with the previous illnesses, and 3rd day I got diaherea


VAERS ID: 1481644 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Back pain, Blood urine present, Chills, Dysgeusia, Fatigue, Headache, Hyperhidrosis, Lymphadenopathy, Migraine, Nausea, Oral pain, Pain, Pyrexia, Tendon pain, Urine odour abnormal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None that day but take maxalt for migraines on needed basis
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: -Severe pain in joints and tendons in both arms (started on left side (injection side) then migrated to the right side as well and back pain -swollen lymph nodes in the left armpit lymph node increased to 2-3?. Both lymph nodes in throat (left and right side) significantly increased 1-2? (7/15/21 through today 7/17/21) -mild fever highest recorded 102F (11pm 7/14 through 7/16/21) -major sweat spells (7/15-7/17/21) -tinted -very light pink urine twice. First time 7/15/21, second 7/16/21. Seems like blood in Urine noticeable on toilet paper, odor similar to blood/metallic -throbbing pain in my lower right back not constant on 7/16/21, today currently not experiencing this -major body aches and chills 7/15/21-today -inside of mouth on the inside of my lips/cheeks tender and metallic taste -headache but today 7/17/21 major migraine -tired and low energy all days -nausea on/off all days -major


VAERS ID: 1481647 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-01
Onset:2021-07-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, 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: N/A
Current Illness: N/A
Preexisting Conditions: Fibromyalgia Epstein Barr
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Red sometimes itchy rash 1 week past injection day


VAERS ID: 1481664 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO187 / 2 LA / SYR

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

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

Write-up: Fever, headache, swollen lymph node under arm, extreme fatigue, nausea.


VAERS ID: 1481665 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Insomnia, Loss of personal independence in daily activities, Pain, Pain in extremity, Pulmonary pain
SMQs:, Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Lisinopril, Glipzide, Atorvastatin
Current Illness: None
Preexisting Conditions: Diabetes and Herpes Type 2
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I was afraid to receive any of the none PDA approved vaccine shots because of side effects. After my 1st dose i felt pain later that day and i had diarrhea. My left arm was sore and my left lung hurt worse. I know the arm is supposed to hurt but not my lung. After two days my arm didn''t hurt as much but it''s day three and my lung still hurts so bad. With every move i make my lung slows me down. I haven''t been able to do my daily task or sleep at night. I just want the pain to go away. My family and friends are scaring me by saying that i might have a blood clot developing in my lung. Today i have taken Tylenol to ease the pain and i made my own ice pack. If there''s no change by morning i''m going to the ER. This pain makes me not want to get my second dose.


VAERS ID: 1481667 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Headache, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: anxiety, alcohol consumption
Allergies: nka
Diagnostic Lab Data: Covid testing and telehealth follow-up appointment 2-3 days.
CDC Split Type:

Write-up: Patient received Pfizer vaccine 7/15/2021 and developed headache, fever and backache. Came to urgent care, was assessed by dr. Tested for Covid and will follow-up via telehealth within 2-3 days.


VAERS ID: 1482062 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Cellulitis, Feeling hot, Hypersensitivity, Injection site induration, Injection site mass, Injection site rash, Injection site reaction, Injection site swelling, Injection site warmth, Pyrexia, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Six days after the shot (Thursday morning 07/15) my left armpit was sore. The following evening (Friday 07/16) I noticed red bumps/rash on my upper arm where the injection site was; it resembled and insect bite. Throughout the evening, the red bumps turned into a painful, itchy rash with hot-to-touch hard lump, that was about the size of a quarter. The next day (Saturday 07/17) the rash had progressed and worsened; it is very hot to touch, large lump under skin, swollen, very red. The area had grown to consume most of my upper arm. Later Saturday afternoon, I began to feel very hot, took my temperature and had a fever 100.00 and decided to go to an urgent care. I was diagnosed as an allergic reaction and cellulitis. I was giving three shots: 1. Decadron and the other two shots were Clindamycin. I will begin Clindamycin capsule tomorrow.


VAERS ID: 1483739 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram, Electrocardiogram, Laboratory test, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: labs drawn (Troponin and CRP elevated), EKG completed, ECHO completed
CDC Split Type:

Write-up: Chest pain for 2 days came to ER,


VAERS ID: 1483784 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM

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

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

Write-up: Patient had red rash that spread out all throughout his upper arm. Dark red in the center. Started occurring 6 days after the vaccine and necessitated an ER visit on Sunday


VAERS ID: 1483818 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site rash, Periorbital swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Starting the night of the vaccine the patient started to feels chills, then the next morning she had a fever of 101 degrees which lasted for a day. She also is experiencing a rash at the injection site and swelling under her eyes that still persists from the day after the vaccine to now 3 days later.


VAERS ID: 1483872 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, 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: N/a
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, itching and hard bump in injection site


VAERS ID: 1483880 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none known
Preexisting Conditions: hashimoto''s disease
Allergies: penicillin, codeine
Diagnostic Lab Data: Physical examination on 7-17-21
CDC Split Type:

Write-up: The patient developed mild swelling and redness developing over 2 days extending from below the injection site down approximately 4-6 inches. She went to urgent care for evaluation. The provider ruled out allergic-type reaction, recommended topical Benadryl cream and redness and swelling went down within 24 hours.


VAERS ID: 1484011 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-08
Onset:2021-07-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site rash, Injection site swelling, Pain in extremity, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None other than mild allergic asthma.
Allergies: Sulfa antibiotic, ash tree pollen, both types of dust mites. Sulfa antibiotic causes anaphylaxis. And bee venom allergy.
Diagnostic Lab Data: None but I have photos of the rash on day 8 and day 9
CDC Split Type:

Write-up: On day 8 after receiving the first jab, began to experience tiny itchy bumps all around the inj site. Approximately 3 inches wide. I had only severe arm pain for the 8 days prior. On day 9 after the itchy rash occurred, I began to get swelling 4 inches wide/long around injection site and the skin turned hot pink. I?m currently on day 9, today.


VAERS ID: 1484027 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Back pain, Fatigue, Gastrooesophageal reflux disease, Immediate post-injection reaction, Malaise, Musculoskeletal chest pain, Myalgia, Nausea, Pyrexia, Shock
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: H1N1
Other Medications: Zyrtec, Soliqua, Metformin, Prozac, Zubsolv, Simvastatin, Metoprolol, Estradiol, Progesterone, Lidocaine, Ibuprofen, multi vitamin, potassium, magnesium, B-12, Biotin, Lecithin, Milk Thistle, Tumeric, Fiber capsule, Trilligy Ellipta, Flonas
Current Illness: None
Preexisting Conditions: Arthritis for 30 years, degenerative disc disease, arrhythmia, anaphylaxis
Allergies: Penicillin, Levaquin, melons, avacados, shell fish, morphine, cucumber
Diagnostic Lab Data: Answe to next question: Mostly recovered. Still some abdominal pain.
CDC Split Type:

Write-up: Within 5 seconds of injection I immediately experienced a triggered fight/flight reaction with perspiration that turned into the feeling of shock, within an additional 5 seconds. Full event lasted less than 1 minute. Then, I began feeling acid reflux which intermittently continued through the next 24 hours. The reflux lessened within 36 hours. Pain began in upper abdomen under lowest ribs, also mid back, on both sides all the way around my upper torso . This has continued to date. Otherwise, I experienced similar commonly reported side effects such as joint pain, fatigue, malaise, muscle pain, nausea and a slight, short fever occurred within 3 hours of the time of injection, lasting through the first 48 hours.


VAERS ID: 1484032 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-01
Onset:2021-07-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Gabapentin, Clonazepam
Current Illness: none indicated
Preexisting Conditions: not indicated on form
Allergies: Meperidine, Propoxyphene
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported itching beginning at injection site and spreading around to various spots 2 weeks after her vaccine. I checked with her 2 days later to see if it resolved and it had.


VAERS ID: 1484076 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-04
Onset:2021-07-15
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Aortic thrombosis, Arterial thrombosis, Cardiac operation, Computerised tomogram thorax abnormal, Thromboembolectomy, Vascular operation
SMQs:, Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT scan of the chest that reports the following: filling defect that extends from the mid aortic arch into the right brachiocephalic artery is consistent with the thrombus. There is a filling defect at the origin of the left carotid artery. There is no obvious left ventricular clot. There is a defect in the anterior aorta at the diaphragm.
CDC Split Type:

Write-up: This is not confirmed diagnosis however, part of the immediate differential diagnosis includes possible vaccine related thrombosis. Currently being worked up in the hospital for New - Onset aortic arch thrombus with thromboembolectomy to left arm. Patient has no previous history of blood clots, no family history of blood clots and the location of blood clot is in a very unusual location. Patient developed sudden onset symptoms of left arm arterial thrombosis that required immediate surgical embolectomy to restore blood flow to left arm. CT scan noted large aortic arch thrombosis and transferred to Hospital for escalation of care, cardiac surgery and vascular surgery evaluation. Hematology team consulted to begin workup for hypercoagulopathy.


VAERS ID: 1484077 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blood ethanol, C-reactive protein, Catheterisation cardiac, Chest X-ray, Chest discomfort, Chest pain, Differential white blood cell count, Echocardiogram, Electrocardiogram, Fibrin D dimer, Full blood count, Hepatitis viral test, Lipids, Metabolic function test, Red blood cell sedimentation rate, Scan with contrast, Troponin I
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 1 tablet - Carditone /day. Usually taken at night for past 4 years. 1 - 1000 mcg Chromium Picolinate / day 1- 400 mg Magnesium Oxide / day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBC Jul 17, 2021 Lab BASIC METABOLIC PANEL Jul 17, 2021 Imaging Ct Angiogram Chest W WO Contrast Jul 16, 2021 Imaging CARDIAC CATHETERIZATION Jul 16, 2021 Lab D-DIMER,QUANTITATIVE Jul 16, 2021 Lab TROPONIN I Jul 16, 2021 Lab ACUTE HEPATITIS PANEL Jul 16, 2021 Lab ETHANOL LEVEL Jul 16, 2021 Lab LIPID PANEL Jul 16, 2021 Imaging TRANSTHORACIC ECHO (TTE) COMPLETE 16, 2021 Imaging XR Chest 1 View Jul 16, 2021 Lab COMPREHENSIVE METABOLIC PANEL Jul 16, 2021 Lab TROPONIN I Jul 16, 2021 Lab CBC W/ AUTO DIFFERENTIAL Jul 16, 2021 Lab SEDIMENTATION RATE, AUTOMATED Jul 16, 2021 Lab C-REACTIVE PROTEIN Jul 16, 2021 Other type of result ECG 12-LEAD Jul 16, 2021
CDC Split Type:

Write-up: ? 7/13/21 1015AM 2nd COVID vaccine from Moderna received. ? 7/15/21 0200AM (times are approximate) o I started having chest pains in the middle of the night. Sitting or kneeling seemed to relieve some of the pain. It went away after 1500 mg Acetaminophen lasting approx. 3 hrs. ? 7/16/21 (times are approximate) o 0100-0500 Chest pain came back, same style of pressure. No breathing issues. 1500 mg Acetaminophen o 0900 Checked into ER. 7/17/21 Discharged from hospital 330PM


VAERS ID: 1484092 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Headache, Injection site pain, Musculoskeletal stiffness, Neck pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

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

Write-up: Whole body joints pain for 2 days, Injecting site still in pain for 2 weeks now, Tingling whole body starting at 10th day , still ongoing, Left neck(injected at left arm) pain / stifness on and off, Light headache ongoing


VAERS ID: 1484101 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Arthralgia, Chills, Diarrhoea, Fatigue, Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 5 mg Prednisone, 20 mg Lexapro
Current Illness:
Preexisting Conditions: Rheumatoid arthritis
Allergies: Penicillin, Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills and sweats, upset stomach/diarrhea, muscle and joint pain, fatigue. I was not able to take Tylenol or aspirin because I am taking a steroid. Symptoms went away after about 36 hours.


VAERS ID: 1484112 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Lymphadenopathy, Myalgia, Pain in extremity, Peripheral swelling, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), 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), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swollen lymph node under right arm. My entire arm was sore to my finger tip it felt as if my circulation was being cut off in my arm and it lasted about 48hrs. My under arm is still swollen and sore. I did have all the other side affects, fever, chills, dizzy, muscle aches and fatigue.


VAERS ID: 1484286 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 RA / SYR

Administered by: Military       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:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: chills, headache


VAERS ID: 1484465 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 - / IM

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

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

Write-up: PT STARTED FEELING DIZZINESS AND LAID ON THE FLOOR AT HOME. PT STATES SHE FEELS MUCH BETTER AFTER LAYING ON THE FLOOR. PT HOME WITH MOTHER WITH STABLE CONDITION


VAERS ID: 1484473 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Headache, Injection site pain, Myalgia, Pain, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxychloroquine 200mg 2x daily Folic Acid Daily Vitamin
Current Illness: Lupus SLE
Preexisting Conditions: Lupus SLE
Allergies: Latex Benadryl Oyster
Diagnostic Lab Data: none
CDC Split Type:

Write-up: High fever of 103 Chills with severe shakes severe headache that lasted 3+ days where I could not get up body ache pain at injection site 3+ days back pain severe muscle pain


VAERS ID: 1484479 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: Food allergies: wheat, peanut, hazelnut, sesame, tuna, salmon, shrimp
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chest tightness 2 hrs after vaccine administered. 18 hrs and after chest pain exacerbated by light physical activity. Pain becomes sharp immediately after moderate physical activity such as brisk walk/jog. Same symptoms experienced when sick with assumed COVID-19 in October 2020


VAERS ID: 1484511 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levofloxacin, threonyl lactone, vitamin B12, vitamin D3, potassium, magnesium, fish oil, coQ-10, turmeric, probiotics, hair, nail, and skin supplement
Current Illness: none.
Preexisting Conditions: Postpartum stroke at age 32, breast cancer
Allergies: Codine, and hydrocodone
Diagnostic Lab Data: No.
CDC Split Type:

Write-up: About 2 days after vaccination, patient developed a red spot at the injection site. Over the last several days the redness and swelling has expanded to about an inch from the crease of the elbow, and is warm to the touch. Redness and swelling appears to be spreading at this time, 6 days after vaccination.


VAERS ID: 1484514 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-07-15
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Malaise, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10mg, Albuterol HFA, Betimol 0.5% ophthalmic solution, apirin 81mg
Current Illness: NA
Preexisting Conditions: Essential hypertension, carrier of hemochromatosis HFE gene mutation.
Allergies: NKA
Diagnostic Lab Data: Positive COVID-19 PCR test on 05/18/2021
CDC Split Type:

Write-up: Symptoms of COVID which developed on 07/15/2021,


VAERS ID: 1484564 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Nodule, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), 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:
Preexisting Conditions:
Allergies: allergic to penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I began to note a raised itchy bump on my forearm, very small and blister-like on the same day as my shot about 6 hours after the shot. It reminded me of poison ivy. Another bump appeared near the first. In the subsequent days, including today, new bumps have appeared on various parts of the Left side of my body (a cluster of bumps behind my left knee. Two bumps on the left side of my neck. Two bumps on my left underarm. Total of 6 bumps now on my left forearm (below inside of the elbow). Two bumps below my jaw.


VAERS ID: 1484623 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Feeling abnormal, Headache, Insomnia, Lymphadenopathy, Pain in extremity, Restless legs syndrome
SMQs:, Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Arm Pain 6pm, Headache the following 2 days all day long, brain fog the following day of vaccine, Diarrhea 4 days now, glands under arm (same with injection) swollen painful days 3 and 4 after vaccine, 2nd night had insomnia, days 3-4 had restless legs at bedtime.


VAERS ID: 1484669 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-12
Onset:2021-07-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Diarrhoea, Muscle spasms, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin, fish oil, magnesium
Current Illness: None
Preexisting Conditions: Migraines, allergic asthma
Allergies: Penicillin, codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: 7/12/21 extremely painful arm lasting 2 days. 7/15/21 nausea, cramping, diarrhea lasting until 7/18/21 which caused dehydration. Still some nausea today.


VAERS ID: 1484675 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Chills, Echocardiogram normal, Ejection fraction normal, Electrocardiogram normal, Nausea, Pain, Pleuritic pain, Troponin I increased, Vomiting
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lamictal Testosterone (female -$g male transgender) Rizatriptan
Current Illness:
Preexisting Conditions: Seizure disorder Female to male transgender on hormone replacement therapy
Allergies: Procaine
Diagnostic Lab Data: Troponin I level: 3.95 (7/17 6:27 am), 9.15 (7/18 13:10), 7.50 (7/18 19:18) EKG (7/17): normal sinus rhythm, normal axis, normal intervals and no specific ST-T abnormality Echo (7/17): normal ejection fraction (55-60%), no wall motion abnormalities, no significant valvular abnormalities
CDC Split Type:

Write-up: After recieving second dose of Pfizer vaccine, patient developed pchest pain radiating to back the following day. Associated with nausea, vomiting, and chills. Chest pain was also pleuritic. Symptoms improving over the preceding days while in the hospital.


VAERS ID: 1484684 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-05
Onset:2021-07-15
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Pain, Productive cough, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xyzal 5 mg tablet 1 tab(s) orally once a day (in the evening) Premarin 0.3 mg tablet 1 tab(s) orally once a day
Current Illness: unknown
Preexisting Conditions: Fibroid uterus. Fiber cystic changes of breast. Depression. HPV+. Obstructive Sleep apnea.
Allergies: NKDA
Diagnostic Lab Data: COVID PCR tested on 7-16-2021. Result: positive
CDC Split Type:

Write-up: 1. fever, body aches/Pt states she has had phlegm in her throat X 1 month, with sneezing, states she has tried OTC sinus medication and it has not helped. She feels the mucus has now gone into her chest and started with fever and bodyaches yesterday Pt self reported completing PFIZER COVID vaccine series at the beginning of May. I was unable to pull vaccination information.


VAERS ID: 1484690 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-01-12
Onset:2021-07-15
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Influenza, Influenza virus test positive, 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? 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: Based on lab report, patient became symptomatic with chills on 7/15/2021 starting at 05:00. Influenza/COVID-19 Nucleic Acid Amplification Test performed on 7/17/21 at 15:15. Test came back positive. Case investigation interview completed at time of written note, isolation period advised and public health preventative measures have been advised. Case appears to be safe and with family at home.


VAERS ID: 1484699 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

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

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

Write-up: headache, nausea, body aches, myalgias


VAERS ID: 1484765 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-08
Onset:2021-07-15
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 RA / 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? 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: COVID positive PCR after being vaccinated.


VAERS ID: 1484830 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / IM

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

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

Write-up: The recipient is 16yo and received Moderna, which is only approved for 18 and over.


VAERS ID: 1484847 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021CZ1A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Autoimmune thyroiditis, Breast pain, Breast swelling, Condition aggravated, Hypothyroidism, Sleep disorder
SMQs:, Angioedema (broad), Hypothyroidism (narrow), Hyperthyroidism (broad), Lipodystrophy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypothyroid and hashimotos but I manage it through diet.
Allergies: Aspirin. Gluten intolerant.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 1. Painful, enlarged, swollen breasts 2 weeks after 2nd dose. It has been lasting for several days and is still occurring. It hurts to wear a bra. I have to seek help with anti inflammatory medication, acupuncture, and breast massage. 2. Also, I feel my immune system ramped up which is exacerbating my adrenal-thyroid condition and making it difficult to calm down and fall asleep at night.


VAERS ID: 1484865 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

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

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

Write-up: Received vaccine at 3:30 pm on 7/15/21. By 4:00 pm, my son had complaints of sensitivity and soreness. Morning of 7/16/21, he woke with a significantly swollen arm with raised red area and extreme sensitivity. I took pictures due to the significance. Measurements 3" x 3", warm to the touch. Color, dark purple. By Day 3 - 7/18/21, the color faded to a blue bruise, size remains the same, still warm to the touch. Day 4 - 7/19/21, color is fading, but can still see the area affected on his right harm. Since it has been 4 days, we went back to pharmacy today 7/19/21 at 1:00 pm, to show them his arm, and the pictures I took. They referred to this as COVID arm, and immediately recommended I register with VSAFE to track his progress. *Note: VSAFE does not allow any registration for people born after 2005. So, I am tracking information here at VAERS


VAERS ID: 1484868 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-10
Onset:2021-07-15
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Fatigue, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Positive Covid Test received 7/18/2021 in. Symptoms are mild, but fatigue is very bothersome and no taste or smell.
CDC Split Type:

Write-up: Got Covid barely a month after receiving the vaccine


VAERS ID: 1484877 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C214 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Erythema
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma, mitral valve prolapse but no longer needed to have EKGs as it has seemed to have corrected itself as I?ve gotten older
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizzy, lightheaded, hard to breathe, both arms turned bright red Lasted 2 min or so and symptoms started to dwindle on their own


VAERS ID: 1484883 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-18
Onset:2021-07-15
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Myalgia, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/28/2021pfizer,Lot#EN5318 2nd dose: 02/18/21,Pfizer,Lot# EL9266 Diagnosed covid positive:07/15/21 Exposure:Community esposure Symptoms:cough, fatigue,muscle aches,loss of smell/taste, nasal congestion.


VAERS ID: 1484884 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-22
Onset:2021-07-15
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / UNK LA / IM

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

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

Write-up: your coronavirus nasal swab came back positive for SARS-CoV-2, the virus that causes COVID-19. This means that you are actively infected and contagious to others. You must isolate at home to prevent spread of the virus.


VAERS ID: 1484885 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-18
Onset:2021-07-15
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Myalgia, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/28/2021pfizer,Lot#EN5318 2nd dose: 02/18/21,Pfizer,Lot# EL9266 Diagnosed covid positive:07/15/21 Exposure:Community esposure Symptoms:cough, fatigue,muscle aches,loss of smell/taste, nasal congestion.


VAERS ID: 1484887 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-05
Onset:2021-07-15
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 02/12/21pfizer,Lot#EM9810 2nd dose: 03/05/21,Pfizer,Lot# EN6202 Diagnosed covid positive:07/15/21 Exposure:Travel Symptoms:


VAERS ID: 1484892 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-29
Onset:2021-07-15
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose :01/08/21pfizer,Lot# 2nd dose: 01/29/21,Pfizer,Lot# Diagnosed covid positive:07/16/21 Exposure: Symptoms:Fever, head ache.


VAERS ID: 1484894 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-29
Onset:2021-07-15
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Fatigue, Headache, Myalgia, Rhinorrhoea, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: Agency completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/08/21pfizer,Lot# 2nd dose:01/29/21,Pfizer,Lot# Diagnosed covid positive:07/17/21 Exposure: Symptoms:cough, fatigue,muscle aches, loss of smell/taste,chills,runny nose,HA


VAERS ID: 1484956 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH QWO181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 50 mg QD
Current Illness: None
Preexisting Conditions: Depression Obesity
Allergies: NKDA
Diagnostic Lab Data: EKG 7/15/21
CDC Split Type:

Write-up: Chest pain, Bilat Arm Pain, Fever


VAERS ID: 1484992 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-07-01
Onset:2021-07-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Osteopenia after menopause ? Dementia without behavioral disturbance ? History of neck surgery ? Moderate major depression ? Gastroesophageal reflux disease ? Mild intermittent asthma without complication ? Morbid obesity with BMI of 40.0-44.9, adult ? Seasonal allergic rhinitis ? Fibromyalgia ? Spinal stenosis, cervical region ? Connective tissue and disc stenosis of intervertebral foramina of cervical region ? Vitamin D deficiency ? Type 2 diabetes mellitus ? Myalgia ? Essential (primary) hypertension ? Osteoarthritis ? Bilateral hand pain ? Cervicalgia ? Rheumatoid arthritis ? Neoplasm of unspecified behavior of brain ? Trigger finger
Allergies: Levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to the hospital with a pulmonary embolus


VAERS ID: 1485081 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cyanosis, Feeling cold, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (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: ? At approximately 6:50PM vaccine was administered. ? Within 10 minutes of the dose being administered, patient began vomiting. ? At approximately 7:03PM, RN attempted to assess patients pulse. RN determined pulse to be approximately 100 BPM but was difficult to be confident as the pulse was indistinct. Another RN also attempted to collect a pulse and was not confident in a reading. Oxygenation and heart rate was attempted to be collected using a pulse oximeter. A reading could not be determined. Additionally, a temperature could not be collected using an infrared thermometer. Upon observation, the patient appeared pale and diaphoretic. He did not present or report difficulty breathing at any time. Patients skin was cool to the touch. Patient reported to his parents that he felt nauseous and cold. ? At approximately 7:08PM patient was offered juice. ? At approximately 7:10PM RN observed that nail bed began to become discolored, slightly blue. RN requested call 911. ? EMS onsite by 7:15PM. EMS vitals included, o BP 131/88 o HR 103 o Resp. 24 o O2 Sat 98% o Temp 98.4 ? Family declined glucose screen and transport to emergency department as patietn began to report feeling better. Patients color improved. ? EMS, family, and staff left scene at approximately 7:50PM. ? RN connected with patients father on 7/16/21. Father reported that patient was doing much better, slept through the night with no issues. Patient was still sleep when father left for work that morning, however, father looked in on him. Per fathher, his color appeared good and he was sleeping well. Father wondered what gauge needle was used for the procedure. He stated he thought is was long and perhaps a 1 ? ? size. RN assured it was a 1? needle as the type of set-up used was a complete set-up with a standard 1? needle.


VAERS ID: 1485137 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-07-12
Onset:2021-07-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 RA / IM

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

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

Write-up: injection site redness, area warmer, area firmer than surrounding


VAERS ID: 1485172 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blister, Oral mucosal blistering
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Blisters on the hands, feet, and inside mouth. Doctor said they are seeing this in some people with the 2nd Pfizer shot. Told us it should disappear in 10 days maximum.


VAERS ID: 1485236 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Emotional distress
SMQs:, Depression (excl suicide and self injury) (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: Distress


VAERS ID: 1485416 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Chills, Dizziness, Electrocardiogram, Electrocardiogram ambulatory, Feeling abnormal, Headache, Heart rate increased, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: coconut
Diagnostic Lab Data: 7/15/21 at ER i had EKG, heart monitoring, IV fluids, Tylenol via IV.
CDC Split Type:

Write-up: Apx 18 hours after the vaccine was administers my body was sore, aches/pains (my glutes and hamstrings felt like i did 1000 squats), my right arm was sore, i had a terrible headache, chills, & low grade fever. I did not feel right. i was monitoring my heart rate on my wrist band it was very elevated. my resting heart rate was between 120-150 bpm for nearly 12 hours. about 3:20 i started to feel dizzy, anxious, and my heart rate was continuing to claim. I contacted ED advise nurse at 3:21pm the hold time was till 3:42pm when i received a call back. reviewed my symptoms and was told a doctor would call me back about 7pm. When the doctor called, he advise i need to go into the ER for EKG and to verify if i had a blood clot.


VAERS ID: 1485628 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, C-reactive protein increased, Catheterisation cardiac, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram abnormal, Gout, Headache, Inflammation, Myalgia, Pyrexia, Ultrasound chest, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi Vitamins, Prescription Testosterone, Anastrozole
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: Blood work, EKG, CT Scan, ultrasounds of chest and legs
CDC Split Type:

Write-up: Was having normal side effects including headache, fever, muscle aches which started about 6 hours after injections. Roughly 14-16 hours after the injection (8:30-9am) started getting chest pain and slight shortness of breath. Called my PCP and they told me to go to the ER as the chest pain is not normal. At the ER they did an EKG which came back abnormal and I was rushed into a procedure to check my heart including a catheter, ultrasound, and a few more I will provide below. Outcome after all the test was inflammation which I asked if it could have been in other areas of my body but doctor said it was my chest. My C-Reactive Protein level was double the normal level. They put me on 3 medications, Ibuprofen, one for Gout and Prilosec.


VAERS ID: 1485637 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Possible Bell''s palsy To whom it may concern: I am an ED physician, I saw this patient for what appears to be Bell''s palsy. He had his pfizer covid vaccine 1 week ago, and sx started a few days after that. He does not recall when he had the vaccine exactly and could only give estimate dates. He also did not recall the location he got the vaccine when I saw him in the ED. Further information should be obtained through him as I only know the limited information he had provided me.


VAERS ID: 1485643 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-25
Onset:2021-07-15
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, Rosuvastatin 20mg, Quonol. OTC, D3, Nicotinimide, Saw Palmetto, diphenhydramine 25mg, Prilosec 20mg
Current Illness: None.
Preexisting Conditions: None
Allergies: Contrast Iodine
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Tinnitus. A white noise and slightly muffled effect. Hearing acuity doesn?t seem affected. (No hearing test administered)


VAERS ID: 1485984 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-07-12
Onset:2021-07-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Communication disorder, Dysarthria, Fatigue, Vertigo, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily: 500 mg trans-resvaratrol, 2.5 g fish oil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fatigue, weakness for 7 days so far. Neurological symptoms began 2-3 days ago: unable to think of words, saying some things with slurred or mispronounced vowels, tried to scratch nose and stuck my finger in my eye, eyes aren''t focusing right or something like mild vertigo.


VAERS ID: 1485999 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-07-15
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210738457

Write-up: FELT THROAT TIGHTEN; This spontaneous report received from a parent concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 15-JUL-2021 11:30 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 15-JUL-2021, the subject experienced felt throat tighten. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from felt throat tighten on 15-JUL-2021. This report was non-serious.


VAERS ID: 1486580 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild


VAERS ID: 1486584 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 3 LA / IM

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

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

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


VAERS ID: 1486875 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-07-15
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? 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: R56.9 - New onset seizure (CMS/HCC)


VAERS ID: 1486897 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Moderna vaccine
Current Illness: not available
Preexisting Conditions:
Allergies: Not available
Diagnostic Lab Data: no adverse event
CDC Split Type:

Write-up: Patient came with her mother and informed us that she wants moderna vaccine for her son who is 12 years old. My technician typed the prescription as a first dose of moderna vaccine. techinformed me that the vaccine is ready to be injected. I gave the moderna vaccine to the patient and realised that and I spoke to the mother about it and the mother said it is approved by moderna for kids 12years and older and she insisted that, that is what she wants . I advise patient that pfizer vaccine is the only vaccine which is now approved for AUE, for now but patients mother said that is what she wants. There was no reported adverse event. I am reporting because modener has not recievev the AUE aproval from FDA. my recomendation is now as use as off label use


VAERS ID: 1486986 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-17
Onset:2021-07-15
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Intermenstrual bleeding
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, vitamin d3, potassium, magnesium, lecithin, coq10, L Theanine, probiotics
Current Illness: None
Preexisting Conditions: None
Allergies: Septra
Diagnostic Lab Data:
CDC Split Type:

Write-up: I take birth control that doesn?t have a period and I have started spotting. Everyday since it began.


VAERS ID: 1487037 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-11
Onset:2021-07-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Feeling hot, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 57 11/2020 flu shot
Other Medications: I take these daily. Zinc vit c probiotics magnesium. Linisopril 20 mgThe vitamins don''t make me sick
Current Illness: none
Preexisting Conditions: herniated disc in Lumbar vertebrae herniated c7 disc arthritis in spine and joints slight gout premature heartbeats high blood pressure
Allergies: codeine novacaine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: woke up nauseous 2nd daylater drank some coffee I small cup took vitamins threw up kept feeling nauseous from Thursday until Tuesday . At first after vaccine I felt hot then cold no chills.


VAERS ID: 1487081 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-26
Onset:2021-07-15
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Feeling cold, Headache, Myalgia, Oropharyngeal pain, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxyzine, metformin XR, Tri-Sprintec, nortriptyline, sertraline, spironolactone, sumatriptan.
Current Illness:
Preexisting Conditions: PCOS, depression, anxiety
Allergies: Latex
Diagnostic Lab Data: Novel Coronavirus PCR: SARS-COV-2 detected (7/15/2021)
CDC Split Type:

Write-up: Pt is 26 yo female employee at this institution. She is s/p Moderna COVID-19 full vaccination: first dose on 12/31/2020, second dose on 1/26/2021. Underwent voluntary COVID-19 rapid testing on 7/15 after experiencing symptoms including chills, new onset cough, fatigue, muscle/body aches, sore throat, headache, and congestion/runny nose. She reported possible exposure to someone else with COVID-19. PCR test resulted positive.


VAERS ID: 1487097 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-02
Onset:2021-07-15
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Malaise, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none known
Allergies: unknown
Diagnostic Lab Data: positive rapid test 7/20/2021
CDC Split Type:

Write-up: Client was vaccinated for Covid with Moderna vaccines on March 2 and March 30, 2021. Client had Covid symtoms that started on 7/15/2021: runny nose, sneezing, cough, loss of taste and smell. Tested positive with rapid test on 7/20/2021. Reported because this is a case of Covid in a previously fully vaccinated person.


VAERS ID: 1487113 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-07-15
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19
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? 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: 07/20/2021-Encounter For Preprocedural Laboratory Examination (COVID-19)


VAERS ID: 1487121 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-13
Onset:2021-07-15
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036N21A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Headache, Rhinorrhoea
SMQs:, Anaphylactic reaction (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: 7/15- Patient stated that their symptoms started on: 7/15 patient stated he had a headache, mild cough and runny nose. Today he feels better.


VAERS ID: 1487155 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-20
Onset:2021-07-15
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes COPD
Allergies:
Diagnostic Lab Data: Tested on 07/16/21 with the Antigen test at Hospital.
CDC Split Type:

Write-up: Patient contracted COVID-19 and was hospitalized on 07/16/21 after receiving the COVID-19 vaccinations.


VAERS ID: 1487195 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Vaccine was mixed with sterile water instead of sodium chloride. there were no know ADE.


VAERS ID: 1487233 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Scan
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SCAN AT ER CARE MONITOR AT ER
CDC Split Type:

Write-up: BP DROP 78/53 HR 36-37 WENT TO ER CARE 11:30 PM TIL 10:00 AM WAS TOLD HAD A STROKE TRANSFERRED TO ER 12 NOON TIL 7:30 PM DOCTOR TOLD HER NO STROKE RELEASED NEXT DAY BP REBOUND TO 170/101 HR 73 STILL RUNNING HIGH 7/20/2021 TOLD TO CHECK WITH CARDIOLOGIST


VAERS ID: 1487281 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-07-01
Onset:2021-07-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Costochondritis, Dyspnoea, Electrocardiogram, Fatigue, Headache, Hypokinesia, Lymphadenopathy, Nausea, T-lymphocyte count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none/ sensitive to Demerol
Diagnostic Lab Data: Friday 7/16, in ER they gave him ECG, cat scan, full blood panels. The only abnormalities were elevated t-cell count, and some inflammation seen in chest cavity.
CDC Split Type:

Write-up: Sudden onset of severe headache, chest pain, difficulty breathing, fatigue and nausea, ~72 hours post vaccination. After 16 hours of bad symptoms that got worse, I took my husband to the ER, as he was having difficulty breathing and moving. (He is normally very fit, active and healthy). In hospital, they ran a battery of tests and found signs of inflammation in chest and lymph nodes. They gave him fluids, and intravenous pain meds (acetaminophen, Toradol), which helped slightly. Symptoms diminished slowly over next 24 hours, and he was feeling 90% better by Saturday afternoon.


VAERS ID: 1487295 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, Peripheral swelling, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient began to experience pins and needles in upper lip and left cheek within 15 minutes of vaccination. Later that evening her chin, ears, and around her eyes developed hives and were very itchy. She also developed swelling under both arms the following day.


VAERS ID: 1487315 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol sulfate HFA, ciclopirox 8%, gabapentin, lamotrigine, levetiracetam, mavyret, prazosin
Current Illness:
Preexisting Conditions: chronic hep c
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: shortness of breath , HA, fatigue, nausea and vomiting from date of vaccine until current per patient


VAERS ID: 1487380 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Burning sensation, Dizziness, Head discomfort, Hypoaesthesia, Nausea, Sleep disorder
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: DPT and Prevar admin. together as baby
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: As baby had a severe reaction to DPT and Prevar shots given at same time; high fever, shrill cry and afterwards at times a neurological
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Within 2-3 minutes post vaccine, dizziness, felt like I was going to faint, weak, nauseated, loss feeling both hands, burning pain pressure back of nape of neck which spread to overall head. Sat down right away, pharmacist (? tech ; administered vaccine) were both very attentive. Stayed there 30 minutes. My grandmother who is a nurse was right there with me. I live with my grandmother; and she checked my BP at home: 120/86, Apical pulse 88 regular; rechecked today 7-20-21 and it was 98/78, Apical pulse 72. That night and next one to two days some dizziness and diff. sleeping due to pressure sides of head which is slowly improving and no more dizziness.


VAERS ID: 1487443 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMLODIPINE, PIOGLITAZONE, TRIAMTERENE, METFORMIN
Current Illness: NONE PER PT
Preexisting Conditions: DMII, HTN
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: BELLS PALSY PER MD


VAERS ID: 1487461 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Headache, Influenza like illness, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: New Chapter Brand Multi Vitamin for Women Over 40, includes herbal blends
Current Illness: None
Preexisting Conditions: Type 2 Diabetic
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Developed flu like or COVID like symptoms: headache; body aches, chills, felt feverish but did not show fever when temperature taken; extreme fatigue; dry cough. This has been happening for 5 days now.


Result pages: prev   259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=358&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166