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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 376 out of 6,867

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VAERS ID: 1474052 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test, Headache, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Polyneuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Mild intermittent asthma
Allergies: Peanut
Diagnostic Lab Data: MRI Spine, MRI Brain, blood work
CDC Split Type:

Write-up: Polyneuropathy in bilateral legs, headache, and weakness 24 hours after first dose of Pfizer with worsening over subsequent 48 hours - currently being admitted to hospital for evaluation.


VAERS ID: 1474164 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP 7534 / 1 LA / IM

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

Life Threatening? 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: Patient states he had this happen about 10 years ago with flu or tetanus.
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown - no allergies to eggs or vaccines
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was given COVID Pfizer vaccine approximately 13:30. Less than 1 minute later patient went out for a few seconds and was convulsing. Patient was very clammy and sweating. I requested help from RN and we called Dr, our clinical medical director via facetime. He stated he couldn''t move his hands and didn''t know what was happening. He then stated he was have trouble breathing. Dr instructed to administer Epi Pen and call 911. Epi pen was administered at 13:36 to left VL without any complications. EMS arrived at 1341 and took over patient care.


VAERS ID: 1474169 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Headache, Malaise, Muscular weakness, Neck pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever 99.8 for 24 hours; head ache approx 9 hours; joint pain mostly neck, shoulders, hips continues to persist; muscular weakness which persists as well localized primarily to upper extremities; had sharp pains in mediastinum left side, intermittent for several hours the day after the injection, difficult to tell if the pains were heart or lung related. These pains were the most scary part.; General malaise for about 24 hours.


VAERS ID: 1474192 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

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

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

Write-up: no reaction or adverse event


VAERS ID: 1474199 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling hot, Headache, Hypoaesthesia, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Painful arm. Numbess all the way to my fingertips. Headache. Nausea. Hot and cold chills. Achy all over.


VAERS ID: 1474207 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Fever Chills Headache Body aches Tiredness


VAERS ID: 1474215 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-23
Onset:2021-07-13
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 - / IM

Administered by: Work       Purchased by: ?
Symptoms: Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), 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: No
Current Illness: None
Preexisting Conditions: Mental Illness
Allergies: PCN
Diagnostic Lab Data: None as of this date. Will be going to the doctor after work today
CDC Split Type:

Write-up: Possible Bell''s Palsy Facial Droop that became noticeable 2 days ago. Continues with symptoms


VAERS ID: 1474222 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 RA / IM

Administered by: Public       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: 0
Current Illness: 0
Preexisting Conditions: 0
Allergies: 0
Diagnostic Lab Data: 0
CDC Split Type:

Write-up: Moderna vaccine given in error to a child aged 12.


VAERS ID: 1474223 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Metabolic function test, Syncope, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: H/O Seizures from age 1-2.5 years old. Never placed on seizure medication. Seasonal Allergies
Allergies: Loratidine, Green Beans, Pears
Diagnostic Lab Data: CBC, BMP, UA 7/15/2021
CDC Split Type:

Write-up: Patient experienced fainting, syncopal episode.


VAERS ID: 1474226 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 RA / IM

Administered by: Public       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: 0
Current Illness: 0
Preexisting Conditions: 0
Allergies: 0
Diagnostic Lab Data: 0
CDC Split Type:

Write-up: Moderna vaccine given to 13 year old.


VAERS ID: 1474238 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 7/13/21 patient came into the pharmacy to received his second dose, and patient was given the Pfizer vaccination when he should have received the moderna vaccination.


VAERS ID: 1474244 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O45C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Feeling hot, Headache, Hyperhidrosis, Mood altered, Oropharyngeal discomfort, Secretion discharge
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: Daily vitamin, testosterone ciponate (injected), valium, zrytec
Current Illness: Stress induced Diarrhea
Preexisting Conditions: Seasonal allergies, hayfever
Allergies: Aspirin
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Were then 10 the 15 minutes of getting the shot my throat started feeling a little weird with light mucus build-up at the back of my throat. With in a 2 hour timeframe after that I started getting very very hot with profuse sweating and a severe mood change headache almost to where I could not function or think straight. Finally slowly subsided within several hours. The few days following the shot now I have random body aches and light to moderate headaches throughout the day. With a more severe upset stomach on and off.


VAERS ID: 1474278 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 RA / IM

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

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

Write-up: Patient was at a vaccine clinic and completed the Pre-vaccination checklist for Covid-19 vaccine and the patient answered the question asking "Have you ever received a dose of Covid-19 vaccine" and was given dose number 1 of the Moderna vaccine. When I was entering the Moderna vaccine information in the program, I seen that the patient did receive the J & J vaccine on 04/28/2021 Lot # 202A21A Left Deltoid. Unable to reach patient, mailbox is full and unable to leave a message.


VAERS ID: 1474282 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-07-13
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Fibrin D dimer increased
SMQs:, Haemorrhage laboratory terms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi vitamin, acid reflux, licenpril, atenel, lycrica, water pill,Lorraine, baby aspirin
Current Illness: Copd , asthma, high blood pressure, nerve pain, a blood thinner, Barrett dease , acid reflux surgery
Preexisting Conditions: Acid reflux , high blood, COPD, asthma kidney stones
Allergies: Pcn, doxycycline, NSAIDs
Diagnostic Lab Data: Blood work, CT scan
CDC Split Type:

Write-up: Developed chest pain over time, went to dr , had blood work done and the D- Dimer results were extremely elevated, dr requested that more tests be done


VAERS ID: 1474340 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-24
Onset:2021-07-13
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: FLUABV+SARS-CoV-2+RSV RNA Pnl Resp NAA+p~FLU/RSV/Covid-19 by PCR performed on 7/13/2021 at 18:55. Test came back positive. Case investigation interview with patient has not been conducted as of the time of this note.


VAERS ID: 1474345 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-01-28
Onset:2021-07-13
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Blood thyroid stimulating hormone, Cardiac stress test, Chest X-ray, Chest discomfort, Dizziness, Dyspnoea, Echocardiogram, Electrocardiogram, Full blood count, Glomerular filtration rate, Heart rate increased, Hyperhidrosis, Metabolic function test, Tachycardia, Thyroxine, Tri-iodothyronine, Troponin
SMQs:, 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), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (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: Metformin, Farxiga, Trulicity, Fenofibrate, Hctz, Lisinopril, Methimazole, Zyrtec, Aspirin (81 mg), Fish Oil, multi-vitamin
Current Illness:
Preexisting Conditions: diabetes II, hypertension, hyperthyroidism
Allergies: augmentin, z-pack
Diagnostic Lab Data: 3/5/21 - EKG, Chest X-ray, CBC, Troponin, Comp. Metabolic Panel, TSH, T3, T4, GFR 4/26/21 - ECHO, Stress test 7/13/21 - EKG, CBC, Troponin, Comp. Metabolic Panel, TSH, T3, T4, GFR
CDC Split Type:

Write-up: 1st event-3/5/21: normal workday activity, became short of breath with a constricting feeling and not able to take a deep breath. pulse elevated, blood pressure elevated. sweaty and lightheaded. after focused deep breathing, all resolved to normal. 2nd event-7/13/21: workday activity included work-inventorying and moving supplies and equipment; after a normal paced walk and normal speaking the same SOB with constriction and not able to take a deep breath. elevated pulse, tachycardia, elevated blood pressure, sweaty and lightheaded. after focused deep breathing, return to normal


VAERS ID: 1474362 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Intensive care, Oxygen saturation decreased, Pyrexia, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (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: Calcium Carbonate Onfi Depakene Pulmicort Proventil Albuterol Atroprine Atrovent PhosMak Packets Miralax Sodium Chloride via nebs Melatonin
Current Illness: 12P Partial Trisomy Syndrome Generalized Convulsive Epilepsy Restrictive Lung Disease Scoliosis Hypotonic cerebral palsy Spastic Quadriparesis History of aspiration events Global Developmental dely
Preexisting Conditions: See above
Allergies: Chlorhexidine gluconate-wipes cause skin rash
Diagnostic Lab Data: Admission to PICU
CDC Split Type:

Write-up: Approximately 22 hours after receiving Pfizer vaccine #1, he became febrile to 100 degrees fahrenheit, and desaturated down to mid 80% on RA requiring O2 via NC at 2l. Was taken and admitted with impending respiratory failure.


VAERS ID: 1474418 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-13
Onset:2021-07-13
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Romberg test
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Negative
CDC Split Type:

Write-up: Patient developed right sided Bell''s Palsy. Prescribed.. valACYclovir 1 g oral tablet, one three times daily, # 21 predniSONE 20 mg oral tablet, 3 tablets once daily for 7 days, # 21 Patient will follow up in clinic in 1 week.


VAERS ID: 1474563 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-06-30
Onset:2021-07-13
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Injection site warmth, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Potassium, Chlorthalidone, Metformin, Topiramate, Phentermine
Current Illness: N/A
Preexisting Conditions: High Blood Pressure
Allergies: Penicillin, morphine, allergic to mold, regular seasonal allergies
Diagnostic Lab Data: Waiting to be scheduled for ultrasound.
CDC Split Type:

Write-up: Arm was just sore for a couple days after the shot at site of injection. It got better after a couple of days. On Tuesday, July 13 at approx 9:30 pm the arm started hurting just below the injection site and felt warm in that one spot. I had on a tank top and it was cool in the bedroom. It is now Thursday afternoon and it is still sore and warm to touch in that spot and the arm is a slightly weak and sore feeling all over. Not too bad. It is not getting worse, just not any better. I just went to the doctor and she is sending me to have an ultrasound just to be on the safe side to rule out a blood clot.


VAERS ID: 1474582 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-07-13
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anion gap, Basophil percentage, Blood chloride increased, Blood creatinine normal, Blood culture, Blood glucose normal, Blood lactic acid decreased, Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood urea normal, C-reactive protein increased, COVID-19, Carbon dioxide decreased, Chest discomfort, Chest pain, Elliptocytosis, Eosinophil percentage, Glomerular filtration rate decreased, Haematocrit decreased, Haemoglobin decreased, Immunosuppressant drug level, Lymphocyte percentage decreased, Mean cell volume normal, Monocyte percentage increased, Neutrophil percentage increased, Orthopnoea, Peripheral swelling, Platelet count normal, Platelet morphology normal, Polychromasia, Red blood cell count decreased, Red blood cell elliptocytes present, Red blood cell macrocytes present, Red blood cell microcytes present, Red blood cell sedimentation rate increased, Red cell distribution width normal, SARS-CoV-2 test positive, Transaminases increased, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen (TYLENOL) 500 mg Oral Tab Sig: Take 1 tablet by mouth every 6 hours as needed Note (4/21/2021): Ld 4.14.2021 Ascorbic Acid 500 mg Oral Tab Sig: Take 1 tablet by mouth 3 times a day after meals With iron supplements Note (4
Current Illness: Transplant med maintenance
Preexisting Conditions: Asthma, Hx of heart tranplant, hx of cardiac arrest, cardiac allograft vasculopathy, scoliosis, hypomagnesemia, long term immunosuppression therapy, Major depressive disorder-full remission, obesity, subclinical hypothyroidism
Allergies: Banana- Nausea/Vomiting NSAIDS - Renal Toxicity Fruit - Dyspnea PCN Class - Hives/rash
Diagnostic Lab Data: Results for as of 7/15/2021 12:44 7/13/2021 03:20 LACTATE: 1.0 BLD CULT RSLT: Preliminary Repor... 7/13/2021 03:35 NA: 140 K: 4.1 CL: 108 (H) CO2: 22 BUN: 13 CREAT: 0.64 ANION GAP4 SERPL: 10 GLUC: 100 GFR-AFRAM: $g60 GFR NONAFR AMER: $g60 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE 7/13/2021 03:40 FK506 (TACROLIMUS): 15.0 7/13/2021 04:53 CRP, SER QL: 4.0 (H) ESR (UNDILUTED): 69 (H) EVEROLIMUS: 2.7 (L) FK506 (TACROLIMUS): 20.6 (H) 7/13/2021 05:30 CORONAVIR PAN 2019-NCOV, NAA, QL: COVID DETECTED (A) 7/13/2021 08:13 7/13/2021 14:44 EVEROLIMUS: 6.4 FK506 (TACROLIMUS): 15.1 7/13/2021 15:55 7/13/2021 17:04 7/14/2021 06:02 NA: 141 K: 4.2 CL: 110 CO2: 23 (L) BUN: 14 CREAT: 0.75 ANION GAP4 SERPL: 8 MG: 1.6 (L) GLUC: 98 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE WBC: 7.2 RBC''S: 4.11 HGB: 10.9 (L) HCT: 33.0 (L) MCV: 80 RDW, RBC: 13.9 PLT: 190 PLT''S, BLD QL, MAN: ADEQUATE NRBC: 0 NEUTROPHILS % MAN CNT: 76 LYMPHS % MAN CNT: 11 (L) MONOS % MAN CNT: 10 EOS % MAN CNT: 2 BASO''S % MAN CNT: 1 ELLIPTOCYTES, BLD QL MICROS: 1+ (A) MACROS: 1+ (A) MICROCYTES: 1+ (A) OVALOCYTES, BLD QL, MICRO: 1+ (A) POLYCHROMASIA: 1+ (A) PLT''S MORPH: NORMAL FK506 (TACROLIMUS): 11.8
CDC Split Type:

Write-up: 20 Y female with h/o of cardiac transplant in 4/29/20 for HCM with history of early ACR 5/2020 treated with rATG and steroids and early CAV 1 (20% mRCA lesion) on prograf and zortress. Admitted on 7/13 with symptoms of chest pain, lower extremity swelling, chest pressure and orthopnea for rule out rejection. Found to be COVID positive on transfer. On 7/13 underwent a EmBx that revealed 1R/1A. Today, on 7/14, patient denies symptoms of chest pain. Due to COVID hospitalization, patient will be given EUA of Casirivimab and Imdevimab intravenous administration prior to discharge. Deemed stable for discharge. HX OF orthotopic heart transplant on 4/29/2020 at with hypertrophic cardiomyopathy - tacrolimus/everolimus/pred immunosuppression -- tac goal 8-10 -- everolimus goal 3-8 -- current prednisone dose 5 mg daily -- RTC in 1 month for OV -- lab work on Friday - OIP: -- CMV: D+/R+- valganciclovir -- Toxo/PCP: TMP/SMZ -- fungal: posaconazole (for 3 months after last rATG ~ 8/22/2020) -CV: on pravastatin - delayed d/t elevated transaminases - osteoporosis: zoledronic acid 5mg 5/11/2020 COVID positive --appreciate ID; Casirivimab and Imdevimab today -isolation precautions


VAERS ID: 1474584 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 LA / IM

Administered by: Work       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was 16 years old and 8 mos. The mother was present and requested that Moderna be given and was given a VIS for her and for her Son receiving Moderna. They proceeded with Vaccination. After the vaccination, the vaccinator realized the patient was actually younger than he looked as she was entering in the documentation / demographics. She promptly called the mother and informed her of the facts of Moderna for 18 and up however, per CDC the recommendations are for the 2nd Moderna to be given as per normal in 4 weeks. No side effects and no afteraffects. Encouraged mom to call if any issues.


VAERS ID: 1474619 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-08
Onset:2021-07-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Circumoral swelling, Paraesthesia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (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? Yes
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: NICKEL
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: HIVES, SWELLING AROUND MOUTH, HAND TINGLING


VAERS ID: 1474703 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

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

Write-up: Red oval at injection site and another red patch roughly an inch below. Itches madly at times. This is the third day. Second spot developed today.


VAERS ID: 1474708 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-11
Onset:2021-07-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Catheterisation cardiac normal, Chest pain, Echocardiogram, Ejection fraction normal, Magnetic resonance imaging heart, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: Cardiac MRI with findings of myocarditis + high sensitivity troponin of 1673 ECHO with EF 56% and no wall motion abnormalities.
CDC Split Type:

Write-up: Myocarditis with cardiac cath with normal coronary arteries. + troponin. Symptoms of chest pain onset 2 days post vaccine.


VAERS ID: 1474712 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram normal, Defect conduction intraventricular, Dizziness, Electrocardiogram abnormal, Eye movement disorder, Loss of consciousness, Seizure like phenomena, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: About 11 hours after vaccine, woke up at around 4:45AM. Got up to go pee. Peed. Stood up and took a few steps. Felt like I was going to pass out so laid down on ground. Seconds later, passed out for about 10 seconds and eyes rolled back (according to my husband). Woke up and started to lift head and passed out again with seizure-like activity. About an hour later, did ECG and CT and was monitored at hospital. CT was normal. ECG said Nonspecific Intraventricular conduction delay 115. Emergency department thought it was vasovagal syncope possibly related to the Covid-19 vaccine. (Note: this was my second dose of Pfizer vaccine. First dose was given to me in another country on June 19, 2021: Comirnaty - EU/1/20/1528, 1119349007 SARS-CoV-2 mRNA vaccine, Biontech Manufacturing GmbH. Did not have any side effects after first dose).


VAERS ID: 1474736 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-04
Onset:2021-07-13
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL92261 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Laboratory test, Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Humalog KwikPen, Lantus Solostar, Metoprolol succinate, multivitamin, quetiapine, simvastatin, Thiamine HCL,Vit V12, apixaban, Ca Carbonate Vit D3 docusate sodium,polyethylene glycol
Current Illness:
Preexisting Conditions: DM, MGUS, CKD stage 3, poly rheumatica, atrial fib
Allergies: Trees, pollen
Diagnostic Lab Data: Tested on 7/13/21- results returned 7/14/21
CDC Split Type:

Write-up: no symptoms


VAERS ID: 1474758 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / IM

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

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

Write-up: RPH GAVE VACCINE ON THE 3RD WEEK INSTEAD OF GIVING IT 4 WEEKS AFTER THE 1ST DOSE.


VAERS ID: 1474803 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-06-02
Onset:2021-07-13
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Pericardial effusion
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had Small pericardial effusion. noted as an incidental finding on a CT heart score


VAERS ID: 1474809 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-09
Onset:2021-07-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 RA / IM

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

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

Write-up: Patient reported on 7/15/21 that she started developing chest pain on 7/13/21 and 7/14/21 off and on. She received 1st dose of Pfizer Covid vaccine on 7/9/21. On morning of 7/15/21, the chest pain returned and was a mostly constant, dull chest pain. The patient reported this to the pharmacy around 4 pm on 7/15/21. She said she was not having any shortness of breath or any other symptoms. I advised patient to go to urgent care to be evaluated. Patient agreed to go to urgent care and would inform pharmacy of the outcome.


VAERS ID: 1474814 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-07
Onset:2021-07-13
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Noe
Diagnostic Lab Data: In progress.
CDC Split Type:

Write-up: Bell''s Palsy. Facial paralysis on one side. Onset 7/13/2021 Outcome uncertain. Treatment just started.


VAERS ID: 1475199 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-26
Onset:2021-07-13
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Oropharyngeal pain, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID TEST POSITIVE ON 07/14
CDC Split Type:

Write-up: PATIENT DEVELOPED COUGH, BODY ACHES, HEADACHE, AND SORE THROAT ON 07/13 AFTER SHE HAD BEEN FULLY VACCINATED FOR COVID. COVID TEST POSITIVE ON 07/14


VAERS ID: 1475204 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-31
Onset:2021-07-13
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 07/14
CDC Split Type:

Write-up: PATIENT DEVELOPED COUGH, FEVER, LOSS OF TASTE OR SMELL, MUSCLE ACHES, HEADACHE, AND RUNNY NOSE ON 07/13 AFTER EXPOSURE TO HER HUSBAND WHO IS ALSO POSITIVE FOR COVID. PATIENT TESTED POSITIVE FOR COVID ON 07/14


VAERS ID: 1475422 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-06-18
Onset:2021-07-13
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / UNK LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / UNK LA / IM

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

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

Write-up: positive Covid test on 7/13/21


VAERS ID: 1475431 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-01
Onset:2021-07-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / SC

Administered by: Other       Purchased by: ?
Symptoms: Anal incontinence, Diarrhoea
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: 2yrs old -smallpox vaccine
Other Medications: Adderall, xanax, valsartan, clonidine, multi vitamin, vit B complex, calcium, magnesium, zinc, iron
Current Illness: No
Preexisting Conditions: CKD3,
Allergies: Airborne- hay fever, pets, dust, oak, cockroach,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up 0630, unknowingly had diarrhea,sat up, felt wet, went to toilet and had explosive diarrhea, showered, finished toweling when it began again and continued uncontrollably for about 40 min. Have been tired since. NEVER EVER HAPPENED BEFORE!


VAERS ID: 1477738 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Lethargy, Somnolence, Vertigo
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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: Asthma inhaler
Current Illness: Surgery June 22 achalasia
Preexisting Conditions: Asthma achalasia
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Lethargic, drowsy, nausea, feeling of not being able to breathe dizziness not a regular feeling for me. I was almost afraid to walk around alone for fear of falling from vertigo effect.


VAERS ID: 1477779 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 UN / 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? 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: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1477783 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dizziness, Dyspnoea, Flushing, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe


VAERS ID: 1477784 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Flushing, Hyperhidrosis, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe


VAERS ID: 1478020 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-02
Onset:2021-07-13
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Polymerase chain reaction positive
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: afib
Allergies: no
Diagnostic Lab Data: PCR 07/13/2021 POSITIVE
CDC Split Type:

Write-up: PCR POSITIVE 07/13


VAERS ID: 1478033 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWA80 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st dose of Pfizer Covid19 vaccine caused same reaction.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Shrimp allergy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, generalized body aches, and diarrhea from 4pm on 7/13 until 7/15.


VAERS ID: 1478048 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Patients blood pressure was checked by the ambulance crew and found to be normal. Patient refused any further treatment
CDC Split Type:

Write-up: The patient was sitting in a chair in our waiting room as we request after a vaccine with her soon to be mother in law. After about 5 or 10 minutes her mother in law said shes not feeling well to my technician who was visible from her seat. He called me to her and I went to help. The patient put her head back while she was seated and stated that she wasn''t feeling well and was breaking out in a sweat. She then stated her vision was blurry and felt like she was going to throw up. I had my technician call 911. I asked her if she thought she would feel better if she put her head between her legs and she refused stating that she would throw up. We kept her in the chair while her eyes opened and closed and kept talking to her to keep her responsive. She asked for water so we got her a cold bottle and we held it against her forehead which she said made her feel better. After approximately 5 minutes she totally snapped out of it. She wanted a drink of the cold water and I advised her to take small sips. Then two gentleman arrived from the ambulance crew and checked her bp which was normal. They offered to take her to the hospital to get checked but she refused.


VAERS ID: 1478142 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-10
Onset:2021-07-13
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Headache, Myalgia, Oropharyngeal pain, 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? 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: Received Pfizer vaccines on 4/15/21, 5/10/21. Tested positive for COVID19 by PCR on 7/15/21, symptom onset date of 7/13/21; known exposure to COVID-19, symptoms of New headache, New muscle aches, New cough, New sore throat


VAERS ID: 1478189 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Hypoaesthesia, Pain in jaw, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Pt we/ a hx of allergy to treenuts and "vaccine" (anaphylaxis).
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt we/ a hx of allergy to treenuts and "vaccine" (anaphylaxis). 35mins post vaccination, pt c/o chest discomfort (stabing, brief), tingling in Left UE, and Left jaw ache/numbness. BP 121/70, HR 64, RR 16, O2 Sat 99% -- $g 119/65, 63, 98%. NO rash, hives, angioedema noted. Numbness resolved. No further complaints of discomfort, numbness, or tingling. No further reports of abnormal symptoms. Pt stable and released from the vaccination site w/ dad @12:53.


VAERS ID: 1478273 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-07-13
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Computerised tomogram head abnormal, Dysarthria, Facial paralysis, Facial paresis, Haemorrhage, Haemorrhage intracranial, Hemiparesis, Intraventricular haemorrhage, Muscular weakness, Thalamus haemorrhage
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamins C, D, E, zinc, calcium.
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: Penicillin
Diagnostic Lab Data: TECHNIQUE: Contiguous 2.5mm unenhanced axial CT images of the head were obtained with generation of coronal and sagittal reformatted images as per the standard Hospital protocol. The exam was performed with one or more of the following dose reduction techniques: Automated exposure control, adjustment of the mA and/or kv according to patient size and/or iterative reconstruction techniques. FINDINGS: There is an acute parenchymal hemorrhage centered at the level of the left thalamic nucleus measuring 2.3 cm (AP) x 2.4 cm (TV) x 2.3 cm (CC). There is mild distortion of the left lateral ventricle. There is dissection of hemorrhage into the third ventricle. There is a minimal amount of hemorrhage in the atrium of the left lateral ventricle. No hydrocephalus. Cerebral volume is within limits of normal. The gray-white matter differentiation is preserved. The paranasal sinuses are aerated. There are no depressed calvarial fractures. IMPRESSION: Acute parenchymal hemorrhage at the level of the left thalamus with dissection into the third ventricle. The case was discussed with dr at 1020 hrs.
CDC Split Type:

Write-up: HPI 70 y.o. female with pmh of HTN presenting w/aphasia and R sided facial and extremity weakness onset 15m prior to EMS activation. Per EMS, pt may be on anticoagulation, unk meds. LKW 15 minutes prior to activation pt began slurring her speech and spoused noted R facial droop and R sided weakness. Patient unable to provide history based aphasia however cannot yes or no to questions. Pt is no longer taking medications for BP. Patient positive of intracranial hemorrhage.


VAERS ID: 1478358 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-28
Onset:2021-07-13
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute kidney injury, Arthralgia, Back pain, Blood creatinine increased, Dizziness, Hyperkalaemia, Hypoaesthesia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Arthritis (broad), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, atorvastatin, paxil, humalog, melatonin
Current Illness:
Preexisting Conditions: HTN, renal insufficiency
Allergies: contrast dye, shrimp, enalapril
Diagnostic Lab Data: creatinine went up from baseline 1.4 to 3
CDC Split Type:

Write-up: shoulder pain, back pain, numbness and tingling of fingers, dizziness, acute renal failure, hyperkalemia


VAERS ID: 1478420 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse event reported. Vaccine administered to patient 17 year and 2 months old.


VAERS ID: 1478427 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Injection site swelling, Lethargy, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Patient states the the morning after she received the Moderna vaccine she woke up with a fever that took two days to control with Tylenol. It''s been three days and the patient now has diarrhea and nausea. Patient states she is very lethargic and the injection site is still swollen.


VAERS ID: 1478434 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 said after receiving vaccine she noticed that the left side of her face and both feet feel numb. She has not contacted her primary care yet.


VAERS ID: 1478480 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-07-13
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0D0C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Injection site bruising, Injection site pain, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafexine 150 ER Daily Vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: When I received the 2nd shot on 06/01/21 my left arm was sore and bruised, I had no other reactions. I also had Covid prior to my injections in case you need to know. 2 days ago on the 14th my arm started hurting in the injection spot and a bruise showed up again. There was no injury to my arem.


VAERS ID: 1479066 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-09
Onset:2021-07-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram normal, Headache, Myalgia, Red blood cell sedimentation rate increased, Troponin I increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: On 7/9. Headache, temperature at 99, muscle pain for 3 days. No cough. on 7/10 had shortness of breath at night, no chest pain. No palpitation
Preexisting Conditions: hx of latent TB, complete treatment of INH in 2011
Allergies: none
Diagnostic Lab Data: see in item 18
CDC Split Type:

Write-up: Mid sternal chest pain on 7/13/21 after the 2nd dose of COVID vaccine ( 7/9/21), symptom last for 1 hr, spontaneous resolved. hx of shortness of breath at night on 7/10, completely resolved the next morning. headache and muscle aching after vaccination on 7/9/21, last for 3 days. no palpitation. he is seen in office on 7/13/21 due to hx of chest pain in the morning, no current chest pain/symptoms, normal CVS exam, normal EKG. Elevated troponin I/ESR/CRP and normal CBC Troponin I 1.92 ( 0.00-0.04) , ESR 20 ( <15), CRP 3.3 ( <0.9) he again seen in ER the same day for abnormal troponin I results, recheck EKG normal., troponin down to 1.73 he was seen in pediatric cardiology clinic on 7/14/21, troponin 0.68, normal EKG and normal echocardiogram. his symptoms self resolves without medical intervention.


VAERS ID: 1479434 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Cold sweat, Dizziness, Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Passed out 2+ times for at least 30 sec and more over the course of about an hour. Signs were feeling light headed, dizzy, nauseous, chest pains, and clammy.


VAERS ID: 1479630 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-10
Onset:2021-07-13
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Decreased appetite, Fatigue, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, multivitamin, calcium +D
Current Illness: No
Preexisting Conditions: Hypothyroidism
Allergies: Sulfa allergy
Diagnostic Lab Data: COVID-19 test 7/15/21 positive
CDC Split Type:

Write-up: Fever, chills, body aches, cough, congestion, loss of appetite, fatigue


VAERS ID: 1481195 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-07-13
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210727826

Write-up: ADMINISTERED EXPIRED VACCINE; This spontaneous report received from a health care professional 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: 1805031, expiry: 10-JUL-2021) dose was not reported, administered on 13-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-JUL-2021, the subject experienced administered expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administered expired vaccine was not reported. This report was non-serious.


VAERS ID: 1481208 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-13
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache, Hyperventilation, Nervousness, Pain in extremity, Paraesthesia, Swelling, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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:
Current Illness:
Preexisting Conditions: Comments: The patient had no any medical history.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210728044

Write-up: NERVOUSNESS; TINGLING SENSATION IN BODY/TINGLING IN THE ARMS AND FEET; FELT FAINT; HYPERVENTILATION; SHORTNESS OF BREATH; HEAD FELT COMPLETELY SWOLLEN; TACHYCARDIA; PAIN IN ARM; HEADACHE; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no any medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 2021, the subject experienced tingling sensation in body/tingling in the arms and feet. On 2021, the subject experienced felt faint. On 2021, the subject experienced hyperventilation. On 2021, the subject experienced shortness of breath. On 2021, the subject experienced head felt completely swollen. On 2021, the subject experienced tachycardia. On 2021, the subject experienced pain in arm. On 2021, the subject experienced headache. On 13-JUL-2021, the subject experienced nervousness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from pain in arm, tingling sensation in body/tingling in the arms and feet, headache, felt faint, hyperventilation, shortness of breath, tachycardia, and head felt completely swollen, and had not recovered from nervousness. This report was non-serious.


VAERS ID: 1481230 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-07-13
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Dysstasia, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Back pain; Comments: The pain that patient experienced is different from the pain that the patient had in back.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210728619

Write-up: PAIN FROM BACK TO LEG AND BOTTOM OF FEET THEN AROUND STOMACH; NUMBNESS FROM BACK TO LEG AND BOTTOM OF FEET; DIFFICULTY IN STANDING UP STRAIGHT AFTER SITTING; This spontaneous report received from a consumer concerned a 49 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included back pain, and other pre-existing medical conditions included the pain that patient experienced is different from the pain that the patient had in back. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 07-AUG-2021) dose was not reported, administered on 29-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-JUL-2021, the subject experienced pain from back to leg and bottom of feet then around stomach. On 13-JUL-2021, the subject experienced numbness from back to leg and bottom of feet. On 13-JUL-2021, the subject experienced difficulty in standing up straight after sitting. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain from back to leg and bottom of feet then around stomach, and numbness from back to leg and bottom of feet, and the outcome of difficulty in standing up straight after sitting was not reported. This report was non-serious.


VAERS ID: 1481267 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Maine  
Vaccinated:0000-00-00
Onset:2021-07-13
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 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: USJNJFOC20210730775

Write-up: INCORRECT PRODUCT STORAGE; JANSSEN COVID VACCINE DOSE GIVEN AFTER 6 HOUR; This spontaneous report received from a health care professional concerned a 49 year old female. The patient''s weight was 133 pounds, and height was 64 inches. No past medical history or concurrent conditions were reported. The patient experienced confusion and dizziness when treated with isoniazid for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: 07-AUG-2021) dose was not reported, administered on 13-JUL-2021 03:45 for prophylactic vaccination. No concomitant medications were reported. On 13-JUL-2021, the subject experienced incorrect product storage. On 13-JUL-2021, the subject experienced janssen covid vaccine dose given after 6 hour. The outcome of the incorrect product storage and janssen covid vaccine dose given after 6 hour was not reported. This report was non-serious.


VAERS ID: 1481287 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-07-13
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: Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USJNJFOC20210731843

Write-up: BODYACHES; HEADACHE; FEVER; This spontaneous report received from a patient 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, intramuscular, batch number: Unknown) dose was not reported, administered on 15-MAR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow up to request batch/lot number. No concomitant medications were reported. On 13-JUL-2021, the subject experienced bodyaches. On 13-JUL-2021, the subject experienced headache. On 13-JUL-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, fever and bodyaches was not reported. This report was non-serious.


VAERS ID: 1481579 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-12
Onset:2021-07-13
   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 EW0181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Cardiac stress test normal, Echocardiogram normal
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tramadol
Current Illness: none
Preexisting Conditions: neck and lower spine vertebrae issues, hip bursitis
Allergies: Aspirin stomach sensitivity
Diagnostic Lab Data: echo cardio gram, induced stress test. No problems found that I know of,, have not had appointment yet to get details.
CDC Split Type:

Write-up: A-fibalation 27 hours after vaccine. No prior history of a-fib or any heart issues. Started at hospital 7/13/21, ambulanced to other hospital twelve hours later, released 7/16/21.


VAERS ID: 1481650 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 - / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein normal, Chest X-ray normal, Dyspnoea, Electrocardiogram normal, Full blood count normal, Rash macular, Troponin normal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin XL, Clonazepam, Ibuprofen, Prilosec, Spironolactone, Trazodone, Effexor
Current Illness: Viral infection 1 week prior
Preexisting Conditions: Affective Seasonal Disorder, Depression Major, Restless Leg Syndrome, Premenstral Syndrome, Prolapse Utrerovaginal incomplete, Fibromyalgia, Anxiety
Allergies: Amoxicillin, Contrast Dye (Gadolinium), Gabapentin, Nabumetone, Oxaprozin
Diagnostic Lab Data: CBC, CRP, chest x-ray, EKG, troponin which were negative
CDC Split Type:

Write-up: Diffuse Macular rash. shortness of breath. Patient was treated with IV Solu-Medrol and Benadryl. She has been placed on prednisone and Zyrtec outpatient without relief.


VAERS ID: 1481657 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / N/A LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Gait disturbance, Heart rate increased, Hypersomnia, Malaise, Pain, Pain in extremity, Sensory disturbance, Sleep disorder
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate pain in the arm after the injection and it still hurts 4 days later. Every arm movement causes pain. About 8 hours after the injection, I could feel my heart rate rising. I tried to sleep and experienced disturbed sleep. At 3:00 am I woke up and felt terrible. I checked my blood pressure, and it was normal at 105/61, but my heart rate was 99. My resting heart rate is typically about 50. My heart rate doubling provided a terrible sensation. I could barely walk and shuffled around outside to get some fresh air. 3 hours later, my heart rate started coming back down but took a day to get back to normal. Even now, I have lost my appetite, am not eating much, and I just slept 16 hours. I have never experienced any vaccine such as this.


VAERS ID: 1483667 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone Bupropion Lamotrigine Hydroxyzine Multivitamin
Current Illness: None
Preexisting Conditions: Anxiety Depression
Allergies: Sulfa Dairy Soy Cranberry
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea, achy, chills, fever, headache, tiredness All lasted approximately 24 hours


VAERS ID: 1483754 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-11
Onset:2021-07-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C2A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Insomnia, Productive cough, Pyrexia, Respiratory tract infection, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Good Sense All Day Allergy tablets- Cetirizine Hydrochloride Daily Mutlivitamin Astaxanthin Life Extension Adrenal Formula- Holy Basil extract, Ashwagandha exctract, Cordyceps extract, Bacopa extract
Current Illness:
Preexisting Conditions: Celiac disease
Allergies: Environmental respiratory allergies- dust, pollen, mold, cats, etc. Allergic to citrus fruits
Diagnostic Lab Data: None so far. Have not seen a physician about this yet, but may do so in the next few days. It may be noted that patient never tested positive for COVID tests previously in the pandemic, however his wife did in Feb. 2021. Her case was mild. He had no symptoms.
CDC Split Type:

Write-up: Chills and fever started 2 days after the injection. The chills and fever have continued for a week and have intensified. Chills are so intense patient is shivering and shaking when he tries to sleep. Also suffering from what seems to be a respiratory infection. Patient coughed up sputum on Saturday 7/17 what showed signs of infection. Treating this like the flu- patient has taken Tylenol, Advil, Advil Cold & Sinus, Elderberry. Drinking lots of fluids, resting as much as possible, but having difficulty sleeping due to fever, chills, and breathing difficulty.


VAERS ID: 1483796 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-10
Onset:2021-07-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Scheduled cardiologist appointment.
CDC Split Type:

Write-up: Consistent chest pressure beginning day 3 after vaccine. In good health with no previous heart issues. Scheduled appointment with cardiologist.


VAERS ID: 1483814 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood culture, Blood glucose, Body temperature increased, Chest X-ray, Fall, Laboratory test, Magnetic resonance imaging head, Magnetic resonance imaging neck, Magnetic resonance imaging thoracic, Mobility decreased, Muscular weakness, Paralysis, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ampyra, gabapentin, Prozac, Aldactone, baclofen, mirena, zonegran, zolpidem
Current Illness: None
Preexisting Conditions: Multiple Sclerosis
Allergies: Cupronickel, cephalosporin,clindamycin, morphine, penicillins, vancomycin
Diagnostic Lab Data: 7/14/21 In the ER They drew multiple rounds of blood, urine, Covid swab me( Neg) ( I had a high temp, chest X-ray, blood cultures, and was given a neurology consult. 5:30pm- MRI Brain, neck and thorax- no new or enhancing demylinating plaques ( aka , was not an MS flare) 7/15/21- lab work - blood sugar check Q ac/Hs 7/16/21 blood sugar - q AC/ HS 7/17/21- blood sugar - Q ac/ Hs
CDC Split Type:

Write-up: Vaccine given at 2 pm 10-pm - legs were weak and fell taking a shower 1 am ( 7/14)- got up to use the bathroom and legs progressively more weak and fell again 3 am- unable to move from the chest down- could ?flick a toe ? but that was it . Essentially paralyzed 9:30am ( ish) Till I was able to get help and check into the ER . Was taking back within 5-10 minutes Was admitted under Neurology service and stayed for 3 days Getting 1000mg IV solumedrol, monitoring blood sugars, lab work, PT/OT 7/17/21- Discharged to home


VAERS ID: 1483885 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-07
Onset:2021-07-13
   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 EJ1686 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Re''cd covid vaccine in 1/2021. Became covid positive 7/16/21


VAERS ID: 1484049 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-06
Onset:2021-07-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

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

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

Write-up: Covid arm- round red itchy rash that started one week after vaccine was given.


VAERS ID: 1484289 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-07
Onset:2021-07-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mucosal inflammation, Stevens-Johnson syndrome
SMQs:, Severe cutaneous adverse reactions (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: Diabetic ketoacidosis
Preexisting Conditions: Diabetes (type 1)
Allergies: Pork products
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe mucositis/Steven''s Johnson Syndrome.


VAERS ID: 1484471 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Cough, Pain, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (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: i have not gone to any facility yet
CDC Split Type:

Write-up: chills body pain loss of energy cough and congestion joints pain


VAERS ID: 1484539 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-07-12
Onset:2021-07-13
   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 EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cheilitis, Fatigue, Lip swelling, Paraesthesia, Paraesthesia oral, Pharyngeal swelling, Rash macular, Stomatitis, Throat irritation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Had a routine colonoscopy exactly 2 weeks prior to vaccine. Take daily food-based women''s multivitamin, fish oil, magnesium, Vit D3 drops in morning at breakfast
Current Illness: None -- but had a routine colonoscopy exactly 2 weeks prior to vaccine
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: None performed
CDC Split Type:

Write-up: Vaccine administered approximately 5 pm on 7/12/2021 in left arm. Felt left arm tingle right after injection, within 24 hours throat and epiglottis areas felt swollen and had red and white blotches/sores in throat, around uvula, tonsils and surrounding tissues in mouth. Lips a bit tingly as well. Felt very fatigued. As days passed, throat sores increased and migrated on roof of mouth and towards lip region and inside of upper lip had red sores that looked bloody and lips with some swelling and tingling. today, 7/19/21, one week after vaccine was given, throat and lips are almost back to normal, but not quite-still with some mild upper lip irritation, swelling and redness and mild throat irritation and blotches but to a much lesser degree. Did some warm water salt rinses throughout the week, rested, took Advil or tylenol. I did not go to the doctor''s office.


VAERS ID: 1484722 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-12
Onset:2021-07-13
   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 FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Condition aggravated, Decreased appetite, Dehydration, Dizziness, Fatigue, Migraine, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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

Write-up: Migraine, body aches, fatigue, fever, chills, loss of appetite, lightheadedness/dizziness, nausea, dehydration


VAERS ID: 1484792 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-06
Onset:2021-07-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Erythema, Tenderness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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: ESTARYLLA 0.25MG/0.35MG TABLETS
Current Illness: NONE REPORTED
Preexisting Conditions: NON REPORTED
Allergies: NONE REPORTED
Diagnostic Lab Data: PATIENT WENT TO DR ON 07/15/2021
CDC Split Type:

Write-up: PATIENT STARTED 8 DAYS AFTER THE VACCINE DEVELOPING "WHEELS" ON THE UNDER SIDE OF LEFT ARM, CHEST, RIGHT ARM AND UPPER THIGHS. SOME SPOTS STARTED AS BRUISING THAT WAS TENDER TO THE TOUCH, THEN TURNED RED


VAERS ID: 1484836 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-09
Onset:2021-07-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 - / -

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives.


VAERS ID: 1484873 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-29
Onset:2021-07-13
   Days after vaccination:165
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: Asymptomatic COVID-19, 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:
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 01/08/21,pfizer,Lot#EL3248 2nd dose: 01/29/21,Pfizer,Lot# EN5318 Diagnosed covid positive:07/13/21 Exposure:Community Symptoms:Asymptomatic.


VAERS ID: 1484985 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-22
Onset:2021-07-13
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Laboratory test, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT Scan and lab 7/13/2021
CDC Split Type:

Write-up: Pulmonary Embolism Blood Thinners


VAERS ID: 1484990 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Pt reports childhood allergy to PCN - response is a rash
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt arrived for vaccine. He received a vaccine that had expired 3 days prior. No adverse reactions.


VAERS ID: 1485110 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-07-12
Onset:2021-07-13
   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: Private       Purchased by: ?
Symptoms: Laboratory test, Muscle spasms
SMQs:, Dystonia (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: gabapentin, ropinirole, oxycodone, ramipril, asa, omeprazole, pravastatin, escitalopram
Current Illness: n/a
Preexisting Conditions: DM2, depression, pain, gerd, RLS, hyperlipid
Allergies: iodine, fentanyl, bupropion
Diagnostic Lab Data: pending
CDC Split Type:

Write-up: unilateral Right sided muscular spasms in both upper and lower extremities; onset 1 day after injection


VAERS ID: 1485112 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-06
Onset:2021-07-13
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: coumadin, Lasix, Prozac, Synthroid, gabapentine
Current Illness: a.fib, DM2 w/ CKD 4,HTN, gout, high lipids
Preexisting Conditions: a.fib, DM2 w/ CKD 4,HTN, gout, high lipids
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: hosp for covid pneumonia 7/14-7/18


VAERS ID: 1485118 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-26
Onset:2021-07-13
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: o Test date: 7/17/2021 o Test performed: SARS CORONAVIRUS-2 RNA, V o Route: Nasopharyngeal o Result: DETECTED
CDC Split Type:

Write-up: Resides in a household with 2 positive cases, first one tested positive on 7/7/21. Sx onset 7/13/21 with sore throat, muscle aches, headache, fatigue & nausea. Tested on 7/17/21 for COVID-19 which returned as positive.


VAERS ID: 1485127 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-20
Onset:2021-07-13
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER6213 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, SARS-CoV-2 RNA increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: o Test date: 7/17/2021 o Test performed: SARS CORONAVIRUS-2 RNA, V o Route: Nasopharyngeal o Result: DETECTED
CDC Split Type:

Write-up: Resides in a household with 2 positive cases, first one tested positive on 7/7/21. Sx onset 7/13/21 with sore throat, muscle aches, headache, fatigue & nausea. Tested on 7/17/21 for COVID-19 which returned as positive.


VAERS ID: 1485163 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Gastrooesophageal reflux disease, Headache, Hypoaesthesia, Immediate post-injection reaction, Muscle spasms, Myalgia, Nausea, Productive cough, Pyrexia, Respiratory tract irritation
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: gabapentin, glucosamine, MSM, Vit-D3, antihistamines
Current Illness: N/A
Preexisting Conditions: Arthritis
Allergies: nicotine, most foaming agents
Diagnostic Lab Data: None pursued
CDC Split Type:

Write-up: Immediate numbness L-arm/shoulder blade, lungs felt "hot" on inhalation (for 5 days), progressed to mildly productive cough (5 days), nausea & GERD (6 days), headache (7 days so far), intermittent fever (7 days so far), moderate to severe muscle aches mostly upper body, increased nighttime leg cramps, exhaustion (lasted 7 days)


VAERS ID: 1485399 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-11
Onset:2021-07-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shots
Other Medications: Estradiol, progesterone, omeprazole, Strattera
Current Illness: Acid reflux, ADHD
Preexisting Conditions: Acid reflux, ADHD
Allergies: Penicillin, all cillin drugs, all sulpha drugs.
Diagnostic Lab Data: Called doctors office.
CDC Split Type:

Write-up: Rash on back that itches. Hands are still Swollen from 1st shot.


VAERS ID: 1486792 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 - / 2 - / SYR

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

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

Write-up: Minor itch on skin surface all over body


VAERS ID: 1486794 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-01
Onset:2021-07-13
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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: SYMPTOMATIC COVID19 POSITIVE DIAGNOSED 7/15/21


VAERS ID: 1486892 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaesthesia oral, Chest discomfort, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium + vitamin D, Duloxetine, Gabapentin, Levothyroxine, Tylenol, Vitamin B complex
Current Illness: N/A
Preexisting Conditions: Fibromyalgia, hypothyroidism
Allergies: Aspirin, Ibuprofen, Hydrocodone
Diagnostic Lab Data:
CDC Split Type:

Write-up: tongue change sensation, persistent nausea and heavy chest


VAERS ID: 1486907 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 ER2613 / 1 LA / IM

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

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

Write-up: after administration of vaccine, up and about to another chair, next to his friend, to help interpret medical questions. he fainted while sitting on a chair, his friend helped him go down to the next empty chair. pass out about 1 minute, elevated his feet with other chair and applied cool compress on his forehead. awake and alert, gave some water and juice. up and sitting on a chair in the waiting room, friends bought his lunch and was eating. no vomiting and alert and talking.


VAERS ID: 1486958 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-26
Onset:2021-07-13
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (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: Demerol and codeine
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Shingles outbreak. Prescribed Valtrex.


VAERS ID: 1486972 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 ER8736 / 1 LA / IM

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

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

Write-up: The technician was under the impression that you added 1.8 ml of diluent (NaCl 0.9%) to the vial prior to drawing up each 0.3 ml Pfizer dose. She added 1.8 ml of diluent to the non-punctured vial and drew up the first dose correctly. She then proceeded to add another 1.8 ml to the same vial and drew up dose #2, which was administered to a different patient. She then added another 1.8 ml to the same vial and drew up dose #3, which this patient ended up receiving. The patient received a dose that had been over diluted with NaCl (a total of 5.4 ml of diluent had been added to this vial prior to drawing up that 3rd dose). We contacted Pfizer to seek guidance on an administration error and to clarify if another dose was to be given. The representative informed us that Pfizer did not have any specific guidance other than the recommendations outlined by Agency for administration errors, which outlined that doses administered with diluent volume greater than 1.8 ml do not require the dose to be repeated. This was the patients first dose, so the patient will receive their second dose at the recommended interval of 21 days as outlined in Agency recommendations.


VAERS ID: 1487023 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-03
Onset:2021-07-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Chest pain, Chills, Cough, Electrocardiogram ST segment elevation, Electrocardiogram normal, Hydrogen breath test normal, Laboratory test normal, Pleurisy, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Myocardial infarction (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Generic for Flonase Claritin Allergy medication
Current Illness: Only seasonal allergies
Preexisting Conditions: He occasionally gets migraines/abdominal migraines. This is primarily controlled with diet.
Allergies: Neomyasin clindamycin
Diagnostic Lab Data: 7/13/21-Emergency Room. Chest X-ray-normal; EKG showed slight elevation of S-T lines. Due to recent vaccine, lab work was completed. He had normal labs, no triponen found in his blood. Ruled out immediate concerns with heart. 7/15/21- Allergy and Ashtma. Depending on outcome, another EKG at a later date may be requested. 7/16/21- Allergy and Asthma, Dr. Ruled out asthma, breathing test was normal. He believes Patient has seasonal allergies that need better maintained (cough due to post-nasal drip). Prescribed additional nose spray and switching back to Zyrtec. He also believes patient may have Plueritis due to vaccine side effect. If this is correct, he believes the chest pain will resolve itself eventually and as long as additional symptoms do not appear, this is not a serious condition. Next appointment is 8/13/21.
CDC Split Type:

Write-up: We had a preventative EKG completed on 6/26/21 for a baseline before the vaccine as a precaution and I am happy to make these available to you. Vaccine was 7/3/21. Patient started having body chills within 24-48 hours after the shot. He still has daily chills as of 7/20/21. Starting 7/13/21 Patient complained of chest tightness and "pain", localized around the center of his chest and a little below. He has seasonal allergies, including a cough that started acting up 7/11/21. The location of pain and description is significantly different than his normal allergy symptoms. Pain and tightness occurred with stationary activities and would come/go, regardless of whether he just coughed. He still has chest pain and occasional tightness as of 7/20/21. No breathing issues, fever, or other symptoms.


VAERS ID: 1487034 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 ER8736 / 1 RA / IM

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

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

Write-up: Technician was under the impression that you add 1.8 ml of diluent (NaCl 0.9%) to the vial prior to withdrawing each vaccine dose. She added 1.8 ml of diluent to the non-punctured vial and withdrew a 0.3 ml dose, which was correct and given to a patient. She then proceeded to add another 1.8ml of diluent to the same vial and then withdrew dose #2. This patient received dose #2, which contained twice the normal amount of diluent. Another 1.8 ml was added to this same vial and a 3rd dose was withdrawn and given to a different patient. The error was realized when she attempted to add another 1.8 ml to the vial to draw up dose #4 and could not physically add any more diluent into the vial. We contacted Pfizer to seek further guidance on the administration error and whether another dose was required to be given. The representative informed us that Pfizer did not have any specific recommendations themselves regarding the administration error, but stated that we should follow the current recommendations outlined by the Committee. They emailed us the Committee recommendations outlined in Appendix A, which indicate that for doses administered with diluent volume greater than 1.8 ml, do not repeat dose.* (Note: dilution with a volume up to 4.0 ml [which exceeds vial capacity] results in more-than-half of the authorized dose administered). The dose given in error was the first dose and the second dose will be administered to the patient at the recommended interval of 21 days, as specified in Appendix A. No adverse reactions have been reported by the patient as of 7/20/21.


VAERS ID: 1487140 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-01
Onset:2021-07-13
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Influenza like illness, 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: Benlysta, prednisone, lisinopril, gabapentin, sertraline, topiramate, trazodone, albuterol, cetirizine
Current Illness:
Preexisting Conditions: SLE Migraines Hypertension Depression
Allergies:
Diagnostic Lab Data: COVID Positive 7/16
CDC Split Type:

Write-up: No ADR to the vaccine, but patient tested positive for COVID greater than 2 weeks since her previous injection. She started having flu-like symptoms on 7/13. She tested positive on 7/16. She was exposed to her new 8 month old foster baby who tested positive for COVID. She has a history of lupus and takes immunosuppressants. We scheduled her to receive the monoclonal antibody.


VAERS ID: 1487328 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-17
Onset:2021-07-13
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 - / -

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

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

Write-up: Patient hospitalized after testing positive for COVID-19. Patient is fully vaccinated.


VAERS ID: 1487420 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-08
Onset:2021-07-13
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Myalgia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unkown
Allergies: Unknown
Diagnostic Lab Data: SARS CORONAVIRUS-2 RNA, V; Detected
CDC Split Type:

Write-up: Symptomatic, started on 7/13 with fever, fatigue, cough, headache, & muscle aches.


VAERS ID: 1487425 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-08
Onset:2021-07-13
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Myalgia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: SARS CORONAVIRUS-2 RNA, V; Detected
CDC Split Type:

Write-up: Symptomatic, started on 7/13 with fever, fatigue, cough , headache, & muscle aches.


VAERS ID: 1487483 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Breast enlargement, Breast pain, Diarrhoea, Dysmenorrhoea, Headache, Intermenstrual bleeding, Menstrual disorder, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lipodystrophy (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Baclofen As Needed 800 mg ibuprofen as needed Citirizine as needed
Current Illness: None
Preexisting Conditions:
Allergies: Environment Allergies, Seasonal Allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, Diarrhea and Headache developed within 4 hours of getting shot. Menstrual spotting, and cramping, started less than 24 hours after getting shot. Enlarged and painful breasts started with in 48 hours of shot. Spotting and cramping lasted 4 days from onset. Breast symptoms lasted 5 days from onset. Still experiencing lingering headaches and nausea a week later. I have not menstruated in almost ten years. Had a D&C, Hysteroscopy and Uterine Ablation to end my heave periods.


VAERS ID: 1487484 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cyproheptadine 4mg
Current Illness: none
Preexisting Conditions: n/a
Allergies: nka
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient was ending her menstrual cycle on the day of her 2nd Moderna vaccine. She then started to bleed heavy again and has been bleeding now for almost 2 weeks. Her menstrual cycles are always regular and last no more than 4-5 days.


VAERS ID: 1487511 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 EW0177 / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Swollen armpit after receiving second dose of Pfizer vaccine. Still have lump and no improvement.


VAERS ID: 1488510 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-22
Onset:2021-07-13
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Dizziness, Hyperhidrosis, Hypersomnia, Impaired work ability, Pain, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone taken 2 days after first Pfizer vaccination due to burning itching rash on palms of hands and bottom of feet; also asymmetrical rash on lower arms, sides of torso, top of hands and top of toes; inflammation of fingers causing my
Current Illness: Overnight of second Pfizer vaccination woke up with chills, 102.2 fever, alternatively sweating and shivering; aches and joint pain, dizziness. Had to take the day off sick from work. Slept the entire day without eating or drinking until 7:00 pm at which time I felt a bit better. By 11:00 pm I felt feverish again and checked my temperature which was back up to 102 again. Woke up the next morning with absolutely no symptoms.
Preexisting Conditions: None.
Allergies: Pennicillins
Diagnostic Lab Data: I went the next day and was seen by a doctor there who prescribed Prednisone 20 mg tablets. The rash was going a day later and never returned.
CDC Split Type:

Write-up: On day 2 after first vaccine in the middle of the night I developed a burning itching rash on the bottom of my feet and the palms of my hands that got me up out of bed to apply cold water and as that didn''t help, I tried witch hazel which helped enough that I was able to get back to sleep. The next day I had a rash on both sides of my torso, on the backs of my hands and at the base of the upper side of my toes. Also from my armpits on both arms past my elbows.


VAERS ID: 1489774 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01C21A / 2 LA / IM

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

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

Write-up: Patient received their first dose on 24June 2021. Patient then came in and received their second dose on 13July2021, on day 19. Patient has had no adverse reactions. Patient has been notified of their early dosing.


VAERS ID: 1490089 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 UN / IM

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

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

Write-up: Error: Patient too young for vaccine administered.


VAERS ID: 1490258 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 UN / IM

Administered by: Other       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? 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: Patient Too Young for Vaccine Administered-


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