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

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



Case Details (Reverse Sorted by Onset Date)

This is page 39 out of 8,010

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VAERS ID: 1769263 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-02
Onset:2021-10-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3163 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenopia, Malaise, Paraesthesia, Pyrexia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topiramate, Montelukast, Ibuprofen, Adderall
Current Illness: None
Preexisting Conditions: Migraine
Allergies: None
Diagnostic Lab Data: On 10/6/2021, I was evaluated by specialist and had a complete comprehensive eye evaluation completed.
CDC Split Type:

Write-up: On day 2 post vaccination (10/4/21), I woke in the morning as usual. The left eye had the sensation of heaviness that progressed throughout the day. By the end of the day I began to notice the feeling of pins and needles on the skin surrounding the eye (on the brow bone and radiating below). I also noticed my vision had become some what blurry. I also had a low grade fever and generally did not feel well. The symptoms continued for another two days getting gradually worse. I made an appointment with my eye Doctor. She determined that I had developed Herpes Zoster Opthalmicus (re-activation of the varicella virus). She stated that this was likely caused by immunization as I am young and not in an immunocompromised state. Treatment of Acyclovir 800mg, Five times daily was started and follow up in one week.


VAERS ID: 1769473 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-09-15
Onset:2021-10-04
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30/35BA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Cough, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lupron
Current Illness:
Preexisting Conditions: Prostate cancer
Allergies: Lisiopril
Diagnostic Lab Data: Tested COVID negative 10/03
CDC Split Type:

Write-up: Coughing congestion chest pains


VAERS ID: 1769476 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Chills, Pain, Sleep disorder
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Sharp Pains in chest. Had chills and body aches that lasted Passed put after waking up from pain in chest


VAERS ID: 1769483 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse 20mg once daily, citalopram 20mg once daily, drospirenone-EE 3-0.03mg once daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen axillary lymph node in left arm, extending from axilla down side and back


VAERS ID: 1769864 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Costochondritis, Dyspnoea, Lymphadenopathy, Oedema peripheral, X-ray
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Cardic work up, X-rays, blood work maybe more
CDC Split Type:

Write-up: Pt went to urgent care with chest pains and was sent to hospital. pt was hospitalized for a cardiac work up the day after being vaccinated with Pfizer. Presented to ER with chest pain, breathing issues, and a swollen lymph note under left arm. Pt received the Pfizer shot in her left arm. Diagnosis Costochondritis related to the vaccine treated with nsaid and sent home. Pain last a couple of more and has not completely resolve. Pt returned to work 10/7/21


VAERS ID: 1769877 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

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? 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: swelling of the left side of neck


VAERS ID: 1769990 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-10-02
Onset:2021-10-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9808 / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Eye irritation, Eye pain, Ocular hyperaemia, Pain in extremity, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Corneal disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingrix shots (both), and my last flu shot caused arm redness for one day. Shingrix, the doctor took pictures of this and also
Other Medications: Adapalene Topical gel, Atorvastatin 20mg, Clindamycin topical gel, clonazepam 0.5 mg 2x/day, Diclofenac Topical as needed for pain, Dorzolamide Hcl Opth. sol 2%, one drop twice a day to left eye for glaucoma, fluticasone Nasal 50 mcg, hydro
Current Illness:
Preexisting Conditions: Lyme disease, fibromyalgia, degenerative disc disease, arthritis of spine, shoulders, knees, neck, feet and most joints, capsilitis of Rt foot, plantar fasciitis both feet, stage III kidney disease, glaucoma central vision left eye only
Allergies: Amitriptyline, alendronate, entex, penicillin, sulfa drugs, bactrim, serzone, zanaflex, tramadol, synvisc one, methylisothiazolinone and methylchloroisothiazolinone
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Shot was Saturday at noon, late in day Rt. arm hurt, Sunday, arm hurt, but no other symptoms, by Monday, arm was swollen, Tuesday, arm still hurt, was more swollen and turned red approximately 6 x 6" and started to itch; Wednesday arm still hurt, swollen, more red - top to bottom approx 8" and sided to side 7" in an L pattern and itching badly. Over the past couple days it was getting increasingly worse. In addition, my eyes were now pinkish, bloodshot looking and burning and hurting, that''s why I called the doctor. I asked if it could have been from the Covid shot I had gotten as my eyes had also gotten worse Mon, Tues and Wed when I called medical facility, but Dr. hadn''t heard of any adverse effects to the eyes. I was told to put hot compresses on, and moisturizing drops which I had been doing already. Thursday morning I work to much less itching, my arm was now only slightly red, and my eyes were now clear. I don''t know if anyone can figure out if the eye pain and redness was due to the Covid shot or not, but I was told to report it.


VAERS ID: 1770011 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 2000iu, fiber gummies
Current Illness:
Preexisting Conditions: Previous vitamind D deficiency
Allergies:
Diagnostic Lab Data: N/A - I have not gone to the doctor about the palpitations.
CDC Split Type:

Write-up: Strong heart palpitations at night before I go to sleep and when I wake up. They stop during the day and come back at night. I have been getting them almost every night since getting the booster shot. However, they have been getting milder.


VAERS ID: 1770021 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine Norethinedrone Cetirizine Influenza
Current Illness: N=q
Preexisting Conditions: N/a
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Small nodule in arm appeared day 1. By day 3 site had generalized redness in about 2 inch diameter around site.


VAERS ID: 1770411 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-10-04
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211421A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? 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: Test Date: 20211004; Test Name: Body temperature; Result Unstructured Data: 99.9 F; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Name: COVID-19 virus test; Result Unstructured Data: Negative.
CDC Split Type: USJNJFOC20211011905

Write-up: This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 211421A expiry: UNKNOWN) dose was not reported, administered on 21-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-OCT-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 99.9 F. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) Negative, Negative, Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 06-OCT-2021. This report was non-serious.


VAERS ID: 1771076 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-10-04
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 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: USJNJFOC20211012326

Write-up: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned multiple patients. 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: 1820095, expiry: 02-OCT-2021) dose was not reported, administered on 04-OCT-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-OCT-2021, the patient experienced expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired vaccine administered was not reported. This report was non-serious.


VAERS ID: 1771178 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Numbness (specify: facial area, extremities)-Medium


VAERS ID: 1771190 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

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

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient will be monitored by her provider and pharmacist


VAERS ID: 1771191 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-02
Onset:2021-10-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 2 LA / IM

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

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

Write-up: Severe facial swelling (angioedema) reported 2 days after the vaccination, received vaccine Saturday 10/02/2021 without incident, reported back to pharmacy on Monday morning 10/04/2021 reportinf allergic reaction that started early mornin on 10/04/2021, reported to ER then to pharmacy to notify.


VAERS ID: 1771192 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 RA / SYR

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

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

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


VAERS ID: 1771199 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

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

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

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


VAERS ID: 1771439 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Arthralgia, Cough, Diarrhoea, Dysphonia, Fatigue, Headache, Injection site pain, Myalgia, Nasal congestion, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dexketoprofen 25mg 1 every 8 hours
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe arthralgia, myalgias, headache, fatigue, severe pain at injection site diarrhea, nasal congestion, hyaline rhinorrhea, dysphonia, anosmia, ageusia, dry cough 4 day evolution.


VAERS ID: 1771482 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Echocardiogram abnormal, Erythema, Myocarditis, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (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), Hypersensitivity (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: Contrast dye
Diagnostic Lab Data: Echocardiogram- inflamed heart
CDC Split Type: vsafe

Write-up: On Monday morning I started feeling how my arm was getting swollen and red. I thought it was a normal reaction. At 7PM I felt like I was out of breath and someone was squeezing my heart. The next morning I went to a store to ask if this was a normal reaction and they told me to go to the ER. I went to the ER and they did an echocardiogram. Then I was admitted to the hospital. I was having so much pain in my chest. They did a bunch of heart tests and they said my heart was inflamed. They also provoked me a heart attack to see if everything was ok. I was 2 days at the hospital. They told me I could go home. They gave me Lisinopril and Aspirin. Yesterday I felt like a liquid running down my armpit to my chest. My chest still hurts a lot.


VAERS ID: 1771490 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011FZ1A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeding disorder, Illness, Loss of personal independence in daily activities, Migraine, Photophobia, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Have been down and out of my daily routine all week. Was uncontrollably vomiting, and running a fever of 101.2. Had a migraine for days straight. The sight of lights and even medication would not help. Took Tylenol and Motrin. Had troubles eating due to vomiting. I was severely dehydrated and sick for 4-5 days.


VAERS ID: 1771525 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-09-20
Onset:2021-10-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast disorder female, Breast pain, Maternal exposure during breast feeding, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Lipodystrophy (broad), Neonatal exposures via breast milk (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I am a breastfeeding mom. I woke up with pain in my left breast and symptoms of a fever. I realized I had a clogged duct. I notified my doctor. I have been breastfeeding for 13 months and never had a clogged duct before. I used natural remedies and was better within 48 hours.


VAERS ID: 1771618 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Headache, Pain, Paraesthesia, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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: For my 2nd Pfizer covid shot on March 26, 2021, I had essentially the same adverse event as for my 3rd Pfizer booster on October
Other Medications: Atenolol 25 mg Hydroxyzine HCl mg Prevident 5000ppm Booster Gel toothpaste Alendronate Sodium 70mg Latanoprost 0.005% Eye Drops Advil mg Hydrocortisone 1% Cream One A Day ? 50+ Advantage multi-vitamin Calcium + D3 (1000 IU) 500 mg Fish Oil
Current Illness:
Preexisting Conditions: tachycardia, obesity
Allergies: amoxycillin, doxycycline, surgical tape
Diagnostic Lab Data:
CDC Split Type:

Write-up: A little after noon on Monday, October 4, 2021, I received my Pfizer Covid booster (3rd shot). Given that I had had an adverse reaction to the March 26 2nd shot, I was prepared for another adverse reaction to the booster. Within 12 hours of my shot and close to midnight, I began having the expected adverse reaction. It started with tingling in my feet, face, legs and arms, and worsened throughout the night to the point that every part of my body from head to toe ached. It was difficult to move any part of my body without experiencing pain or significant discomfort, and that discomfort disrupted my sleep overnight into Tuesday, October 5. It ached to walk, sit and lie prone. I developed a headache during the middle of the night, and took Advil 400 mg to relieve the headache. I did not feel nauseated, did not have a fever and just let the aches subside until I could physically function again about 30 hours after my booster shot. I drank water and coffee (which helped my headache), and ate saltines and cheese throughout the day on October 5. On Wednesday, October 6 I was back to normal.


VAERS ID: 1771634 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fosamax 70mg, Lipitor 20mg, Vitamin D3, Vitamin D2, Estriol Micronized, no dosage, Hydrocodone 5-325mg., Liothyronine no dosage needed, progesterone 200mg, tofacitinib 11mg.
Current Illness: None
Preexisting Conditions: None
Allergies: Morphine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: An entire .3ml bottle of Covid vaccine was drawn and put in the 2ml sodium chloride diluent. A .3ml covid dose was drawn and administered to the patient. This was the patients 3rd dose


VAERS ID: 1771687 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 LA / IM

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

Write-up: Upon check-in the patient presented and reported she was due for a Pfizer vaccine. The patient confirmed in the exam room prior to vaccine administration she was presenting for her 2nd Pfizer. The Pfizer vaccine was counseled and fact sheet provided. After administration of the vaccine it was discovered that the patient had received Moderna, not Pfizer, as the first dose.


VAERS ID: 1771694 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 RA / IM

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

Write-up: Upon check-in the patient presented and reported he was due for a Pfizer vaccine. The patient confirmed in the exam room prior to vaccine administration he was presenting for his 2nd Pfizer. The Pfizer vaccine was counseled and fact sheet provided. After administration of the vaccine it was discovered that the patient had received Moderna, not Pfizer, as the first dose.


VAERS ID: 1771707 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-28
Onset:2021-10-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Chest pain, Cough, Decreased appetite, Dysphagia, Dyspnoea, Gastrooesophageal reflux disease, Insomnia, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Setraline
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: A call to the doctor has been made as of 10/8 at 9 AM and follow up has not been provided at this time.
CDC Split Type:

Write-up: From October 4th I began experiencing tightness in the chest and some difficulty swallowing. I reported this to the nurse at Educational Services and she checked my saturation levels which were 97. She suggested it could be anxiety. Then on 10/7 I began feeling chronic acid reflux throughout the day along with the tightness in the chest. I never have experienced acid reflux like that even while pregnant. As the day progressed it became increasingly worse. I had difficulty sleeping, shortness of breath and what felt like a lump burning up and down my esophagus. This morning 10/8 I can still feel tightness and slight burning sensation that makes me not want to eat or drink anything other than water. Due to the reflux I''ve also developed a cough.


VAERS ID: 1771837 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM

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

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

Write-up: EXTREME HEADACHE, BODY ACHE


VAERS ID: 1771850 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-24
Onset:2021-10-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

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

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

Write-up: EXTREME HEADACHE RADIATED TO THE BACK AND NECK


VAERS ID: 1771874 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-05
Onset:2021-10-04
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol xl, diltiazem, calcitriol, famotidine, Lasix,
Current Illness: none
Preexisting Conditions: chronic kidney disease, hypertensions
Allergies: ibuprofen
Diagnostic Lab Data: covid 19 positive test
CDC Split Type:

Write-up: got sick with covid 19 even after 2 vaccinations


VAERS ID: 1771883 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-05
Onset:2021-10-04
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: PCN
Diagnostic Lab Data: positive covid test
CDC Split Type:

Write-up: got covid 198 infection after 2 vaccines


VAERS ID: 1771904 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301558A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Product preparation issue
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (broad)

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

Write-up: DOSE INJECTED WAS STRONGER THAN 30MCG/0.3ML . THE VIAL OF PFIZER VACCINE WAS DILUTED IMPROPERLY USING ONLY 1.2ML OF SALINE, INSTEAD 1.8ML, SO THE RESULTING SOLUTION WAS MORE CONCENTRATED. THE PATIENT GOT A 0.3ML DOSE, BUT IT CONTAINED ABOUT 30% MORE ANTIGEN (ABOUT 38.5MCG DOSE). PATIENT WAS CONTACTED AND TO DATE HAS HAD NO ADVERSE REACTIONS OTHER THAN A SORE ARM. REPORT OF EVENT WAS ALSO FAXED TO PATIENT''S DOCTOR FOR INCLUSION IN CHART.


VAERS ID: 1771911 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-01
Onset:2021-10-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Pain in extremity, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tendinopathies and ligament disorders (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sleepy, tired, sore arm over the course of 1 week after booster vaccine with it still ongoing


VAERS ID: 1771923 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-02
Onset:2021-10-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast swelling, Extra dose administered, Lymphadenopathy, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot - almost blacked out with muscle fatigue afterward. Suspected air in the vaccine due to noise when administered 1st Pf
Other Medications: Metoprolol, Amlodipine, Rosuvastatin, diazepam, vitamin d3, multi-vitamin without iron
Current Illness: stomach bug with diarrhea about 1 month prior
Preexisting Conditions: labile hypertension, gerd, anxiety, seasonal allergies/sinus issues with mild asthma, cardiac arrhythmias with decreased LVEF (from prior chemo) breast cancer survivor
Allergies: sulfa, all dyes, codeine, strawberries
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large swelling under left armpit that extends to bottom of breast and looks like it may include a portion of the left breast. Doctor and myself are assuming this is a lymph node swelling event, precipitated by the Pfizer booster shot. We will check at the doctor''s office, if swelling doesn''t go down in a few weeks. In other words, I contacted my primary care physician (who was on vacation) and this was advice given to me by the attending doctor


VAERS ID: 1771943 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-01
Onset:2021-10-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3015582 / 3 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Echocardiogram, Electrocardiogram, Pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xyzal twice daily, 40mg pepcid BID, 2000 Vitamin D, Iron, Flovent, Dynamist 1 spray BID, singulair at bedtime, and zoloft daily.
Current Illness: General cold two weeks prior. Shortness of breath from pre-existing condition.
Preexisting Conditions: Chronic idiopathic urticaria, asthma.
Allergies: Dapsone, Xolair, Methotrexate, plaquenil, and amoxicillin, severe beef and severe pork.
Diagnostic Lab Data: EKG 10/7, Echo 10/8
CDC Split Type:

Write-up: Severe shortness of breath while peak flow was 470 and O2 was 98%. Sharp chest pain on the left side on october 4 which has continued but become an ache.


VAERS ID: 1771956 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Discomfort, Pyrexia, Rash, Vaccination site reaction
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: per patient: "Hi I don?t know if your keeping track of any adverse immune reactions to the booster. I wanted to let the pharmacy know that I develop a painful rash on my arm at the injection sport. I guess it?s called ?covid arm?. The rash is very painful and uncomfortable. My arm feels like it?s on fire. I also had fever for three days. The rash seems to be growing. I read that this covid arm goes away after a week. I am treating it with OTC pain relief cream and antihistamine. If my rash is not better by Monday I will go see my doctor. "


VAERS ID: 1771959 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: POTASSIUM,TRAMADOL,LEVOTHYROXINE,BUPROPION,ZOLPIDEM,DOC SOD,LISINOPRIL,VITMIN B,FISH OIL,OMEPRAZOLE,ASP LOW,GABAPENTIN,CARVEDILOL,MIRTAZIPINE
Current Illness:
Preexisting Conditions:
Allergies: CODEINE,PENICILLIN
Diagnostic Lab Data:
CDC Split Type:

Write-up: FACIAL SWELLING


VAERS ID: 1771979 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-25
Onset:2021-10-04
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E / 2 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UJ686AA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Back pain, Chest X-ray abnormal, Chest pain, Computerised tomogram abnormal, Cough, Electrocardiogram normal, Fibrin D dimer increased, Laboratory test normal, Neck pain, Pain, Pulmonary embolism, Pulmonary oedema
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 5 mg prednisone
Current Illness:
Preexisting Conditions: Thyroid Eye Disease
Allergies: cefnidir & macrobid - GI issues
Diagnostic Lab Data: D-Dimer .62 Chest X-Ray - shows fluid in lower right lung CAT scan shows pulmonary embolism
CDC Split Type:

Write-up: 10/4/2021 - Sudden stabbing pain in upper right chest. Radiates to neck and back, right side 10/5-10/6 - pain subsides, but coughing 10/7 - Stabbing pain in upper right chest more severe, scheduled appointment with PCP 10/7 - PCP (Primary Care Physician) did EKG, D-Dimer and Chest X-ray. D-Dimer positive; X-ray shows fluid in bottom of right lung. PCP orders CAT scan 10/8 CAT scan shows pulmonary embolism. EKG and other heart health tests come back normal. Sent home with 20mg/day apixaban (blood thinner). NOTE: no history of clotting, no risk factors for clotting.


VAERS ID: 1772061 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-03
Onset:2021-10-04
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 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? 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: Tested PCR positive for COVID 10/4/21 after being fully vaccinated.


VAERS ID: 1772115 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301558A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Feeling cold, Injection site pain, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: nut allergies; I get sleepy if I eat too many. That is my only reaction to them.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Booster at 10 am: by 9pm I started getting very very cold and arm was aching and tender where injection was. By 10pm I was in bed shaking, cold; every part of my body hurt terribly. Around 11pm I took an Advil so I could sleep. Took an hour to take the edge off my symptoms but only barely. Slept until 4am & then got up. Still ached from head to toe; very very cold; took Tylenol throughout day and again it barely took the edge off. Miserable 24 hours of symptoms. Started clearing up after 24 hours; still cold, still achy for the next 24 hours. Then very very tired. By today, 10/8, I''m feeling almost normal.


VAERS ID: 1772255 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D211A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chest discomfort, Dental paraesthesia, Ear discomfort, Ear pain, Electrocardiogram normal, Groin pain, Headache, Inflammation, Musculoskeletal stiffness, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot - 2007 - got sick for about three weeks -I remember being really sick for three weeks and it was like the flu like feve
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Medications - Codeine and have two others but can''t remember what they are.
Diagnostic Lab Data: ER- EKG; bloodwork; chest x-ray and gave me some fluids and some Toradol for the pain. Nothing showed up on test results.
CDC Split Type: vsafe

Write-up: That evening, when I received the vaccination, I had tingling behind my teeth and like a small throbbing behind my teeth. Small headache that lasted 40 minutes. Pain in my ears and a muffling sensation. The next day, which was Tuesday, I felt ok when I woke up but was somewhat stiff with body stiffness throughout the day though. That went on all day and into the night. I stayed home Wednesday from work. Early Thursday morning, right leg pain and throbbing in right groin area and that hurt pretty bad. I took Ibuprofen for that. When I woke up Thursday morning, I had chest pressure and that lasted through out the day. I went to Urgent-Care, ER yesterday. I still feel the tightness in my chest. The doctor prescribed some medication for inflammation - Naproxen. He said possibly I have inflammation on the lining of my lungs so he is treating me for that. When I went in to the hospital, I had blood pressure reading of 144/99 and that''s high for me.


VAERS ID: 1772264 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-29
Onset:2021-10-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301305B / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Computerised tomogram thorax, Cough, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, cough, infiltration on chest CT.


VAERS ID: 1772283 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Peripheral swelling, Pruritus, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: swollen arm, warm/hot to touch, itching and burning also had fever on tuesday 10/05/2021 which lasted until wednesday 10/06/2021


VAERS ID: 1772310 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

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

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

Write-up: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium


VAERS ID: 1772324 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Patient previously received 2 doses of the Moderna vaccine. We incorrectly administered the Pfizer vaccine for the 3rd shot. No adverse reactions to report.


VAERS ID: 1772567 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-14
Onset:2021-10-04
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Influenza
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Infective pneumonia (broad), 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: Graves and Hashimoto?s
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Asthma, flu


VAERS ID: 1774912 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-29
Onset:2021-10-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2020 flu and pneumonia simultaneously - suffered rash on arm and chest for 3 or so days.
Other Medications: Multivitamins
Current Illness: No
Preexisting Conditions: MGUS
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Day 7 and 8 after receiving the vaccine, I felt a type of severe fatigue different than I had ever felt before. Suffered pain (4 on a scale of 1 to 10) in leg muscles and joints.


VAERS ID: 1774964 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-27
Onset:2021-10-04
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Hyposmia, Nasal congestion
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonidine; Triamterene-HCTZ
Current Illness: none
Preexisting Conditions: esophageal dysmotility, history of tobacco use, HTNl GERD, gastric ulcer
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough on 10/4/21 That lasted a couple of days, and has nearly resolved. She has some nasal congestion and decreased smell as a result of congestion. She was with her brother 10 days ago, and afterward he ended up getting sick and being diagnosed with COVID-19.


VAERS ID: 1774974 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-01
Onset:2021-10-04
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Diarrhoea, Dyspnoea, Fatigue, Head discomfort, Headache, Nasal congestion, Oropharyngeal pain, Productive cough, Respiratory tract congestion, Rhinorrhoea, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (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: Vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: productive cough, sore throat, headache/heavy feeling, runny, chest congestion, chest tightness, shortness of breath, fatigue, diarrhea-3 times/no blood in stool, sinus congestion, nasal congestion,. starting 10/4/21


VAERS ID: 1774996 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Headache, Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no otc medications
Current Illness: patient declines other illness time of vaccine or month prior
Preexisting Conditions: patient declines chronic or long standing health conditions
Allergies: no known allergies
Diagnostic Lab Data: None patient evaluated in my clinic five days after vaccine and asymptomatic.
CDC Split Type:

Write-up: Patient reports symptoms started 8 hours after second pfizer vaccine. Reports chills, sweats, headache, loss of appeitie, terrible muscle pain, headache x 2 days straight.


VAERS ID: 1775025 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no otc medications
Current Illness: patient declines other illness time of vaccine or month prior
Preexisting Conditions: patient declines chronic or long standing health conditions
Allergies: no known allergies
Diagnostic Lab Data: None ordered. Patient evaluated five days after vaccine and asymptomatic
CDC Split Type:

Write-up: Submitted previous vaers repot 675068 but submitting another form because put duration of symptoms incorrect on previous report. Patient reports symptoms started 8 hours after second Pfizer COVID vaccine. Reports chills, sweats, headache, loss of appetite, fatigue terrible muscle pain and headache for 3 days following vaccination


VAERS ID: 1775040 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain lower, Back pain, Constipation, Dizziness, Ear discomfort, Headache, Hyperhidrosis, Injection site pain, Laboratory test, Musculoskeletal discomfort, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No known illnesses
Preexisting Conditions: No known long standing health conditions
Allergies: No known allergies
Diagnostic Lab Data: Tests pending
CDC Split Type:

Write-up: 10/04/21 @ approximately 10:32 am two minutes or so after injection I started to feel like I was going to faint and I began to get sweaty on my forehead and chest. The pharmacist took my BP at 86/58 after 15 minutes my BP elevated to 93/65. 10/04/21 in pm I began to feel a headache and pressure in my Left ear. 10/05/21 developed soreness in Left arm at injection site approximately 5/10 level of discomfort. 10/06/21 developed pain and discomfort in my Left lateral lower abdominal area and Left lower back area. I developed constipation 10/07/21 symptoms resolved except Left abdominal wall pain


VAERS ID: 1775041 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient is being seen under precautionary measures by cardiologist for baseline assessment
CDC Split Type:

Write-up: Patient had low grade fever and cough for next few days.


VAERS ID: 1775051 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER 3930EA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Chills, Computerised tomogram, Dizziness, Dyspnoea, Echocardiogram, Electrocardiogram normal, Fatigue, Feeling abnormal, Feeling cold, Headache, Heart rate increased, Injection site pain, Malaise, Nausea, Pain in extremity, Piloerection, Pyrexia, Tachycardia, Tremor, Tunnel vision
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None that I am aware of.
Diagnostic Lab Data: I have had EKG''s that have come back normal CT Chest Scan with Contrast waiting for results Echocardiodram will be done 10-13-2021
CDC Split Type:

Write-up: I write you today regarding a severe reaction I had post first covid shot. I received my first Pfizer covid shot Sunday October 3rd at 4pm. Everything I was told to expect after this first shot was normal, some minor fatigue, headache, and slight arm pain at the source of the shot. However, roughly 29 and half hours later I suffered a severe reaction leaving me physically disabled for some time. Below I will explain the event in detail. At 9:40 pm Monday October 4th while in bed I suddenly became violently ill, within seconds of feeling ill. It was like turning on a light switch. Within seconds I had a weird sensation start from the back of my head, running down my back, and into my legs. At the same moment I developed goosebumps and the hair on my body stood tall and became increasingly cold like I was in hypothermic shock. I then began to violently shake throughout my whole body leaving me unable to move willingly for about 5 minutes. If I was standing at this moment in time I would have collapsed on the floor. Leading up to this moment I had increasing pain in my left arm running down into my hand, at the peak of my violently shaking episode, which I believe is known as ?Rigors?, I had hard chest pains, shortness of breath, felt like I was going to faint, puke, and had tunnel vison. I felt like my world was closing in on me during this time. When I was able to function and move while still shaking roughly 5 minutes after the rigors started, I was able to put on my pulse ox and had a pulse rate of 125 BPM. I then proceeded to take a shower. Before the shower I took my temperature at it was at 99.9 degrees. After the long shower I went to my mother?s house just before 10:30pm almost an hour after my attack. We have a Kardia EKG device there which I used 3 times. I did 3 EKG?s while there and had an average heartbeat of 110 BPM and was in Tachycardia, which I know means my heart is over 100 BPM, but I mention this to show that after 40+ minutes I still had an elevated heart rate after hitting 125 BPM with my pulse ox. I can confidently assume that if I was able to take my pulse during my attack it would have been greater than 125 BPM. I also had a 101.2 fever at my mothers. I do not believe the rigors were brought on by this small fever, because I did not have a fever until the rigors were over. Due to these medical abnormalities I went to the emergency room where I was monitored from 11:23pm till roughly 5:30am. Currently I still have tightness in my chest and have moments of small shooting pains in my chest at random times. Since this has happened, I went back0. today (10-6-2021) to ask questions and report this medical event. The person there that administers the shots said I need to follow up with doctors and would not advise taking the second shot due to this reaction, and that yes reactions are common but mirror more like cold symptoms, and that the reaction I had is less common but is known. On 10-8-2021 while getting ready for my CT scan when nurse injected me with saline solution in my right arm, same arm as the short, I had a crazy reaction to the saline solution making my arm super tight, caused my wrist to curl inwards and my fingers into a fist. The staff there when I asked if they have ever seen a reaction like this said no. They didn''t panic but how no idea what to do. after about 5 minutes my arm returned to back to normal. I also want it to be known that I have already had covid, and tested positive 7-17-2021


VAERS ID: 1775061 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Rash, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Generalized maculopapular rash on all limbs and torso.after third Pfizer shot. Started after 24 hours from injection. No reaction to fist two injections.


VAERS ID: 1775062 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 RA / IM

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

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

Write-up: Patient received covid vaccine booster dose 1 month early


VAERS ID: 1775067 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Patient is being followed up by a cardiologist for baseline assessment.
CDC Split Type:

Write-up: Patient had sore arm and low grade fever


VAERS ID: 1775078 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-25
Onset:2021-10-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Labyrinthitis, Vertigo
SMQs:, Vestibular disorders (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: TDap- anaphylaxis 2010 23 valent pneumovax- anaphylaxis 2013
Other Medications: Zoloft 200 mg Wellbutrin 150mg Unithroid 100 mcg Vitamin D 5000 iu Multivitamin Benadryl Oxycodone Dymista Zyrtec Ajovy Zanaflex Phenergan 25mg
Current Illness: None
Preexisting Conditions: Asthma Seasonal Allergies Hashimoto?s Thyroiditis Chronic migraine Depression Anxiety
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I developed an inner ear infection with severe vertigo that I do not think had anything to do with the vaccine.


VAERS ID: 1775123 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-29
Onset:2021-10-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pruritus, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Itch Generalized-Medium


VAERS ID: 1775202 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-10-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F8448 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Decreased appetite, Headache, Memory impairment, Migraine, Neck pain, New daily persistent headache, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VIORELE B/C PILLS, DAILY VITAMINS
Current Illness:
Preexisting Conditions: MIGRAINES
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sleep pattern is off, get 4 hours a night, Daily headaches after waking up, keeping forgetting or losing things, all symptoms started week after #2, 10/7 migraine all day, with pain from my left side temple, down my neck to my shoulder, 10/8 woke up with same migraine (maxalt prescribed not working) last all day, woke up at midnight trowing up every 30 ins to and hour until 4 am. no appetite and migraine still here


VAERS ID: 1775267 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-26
Onset:2021-10-04
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Myalgia, Nasal congestion, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: PCR + for Covid on 10/7/2021
CDC Split Type:

Write-up: Client was vaccinated with Pfizer vaccines in July and August 2021 (client not sure of dates). Symptoms started 10/4: nasal congestion, cough, fatigue, fever 102 x 2 days, myalgia, sore throat. Went to hospital ER on 10/8 and was given IV electrolytes and Tylenol and sent home. Reported as breakthrough Covid illness in previously vaccinated person


VAERS ID: 1775291 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-28
Onset:2021-10-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F158448 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood chloride decreased, Blood creatinine normal, Blood sodium decreased, Blood urea normal, Chest X-ray, Computerised tomogram abdomen normal, Computerised tomogram head, Confusional state, Diarrhoea, Dysuria, Seizure, Specific gravity urine normal, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine 10 mg daily, Bisprolol-hydrochlorothiazide 10-6.25 mg daily, tretinoin 0.1% cream applied topically daily
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: 10/4 9:30 pm sodium 125, Cl 87
CDC Split Type:

Write-up: 10/4 around 11:30 am, had difficulty urinating at PCP''s office to provide a UA sample. Drank maybe 5-8 oz of water. UA was concentrated with spec grav 1.025 but negative for UTI. Within 1-2 hours of PCP visit, had diarrhea and vomiting. Became confused and had a seizure at 8:30 pm. In a local Medical Center, found to have Na 125 and Cl 87, BUN 11, Creatinine 1.1. CT head, CXR, CT abd negative. Received NS and 3% to raise sodium. Discharged home 10/8.


VAERS ID: 1775378 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Chest X-ray, Decreased appetite, Echocardiogram, Electrocardiogram, Fatigue, Headache, Insomnia, Mobility decreased, Muscle spasms, Nausea, Pain, Pallor, Paraesthesia, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin a,c,d,zinc, tudca, minerals, magnesium, tumeric
Current Illness: none
Preexisting Conditions: migraines, infrequent but disturbs functioning, especially if untreated
Allergies: Augmentin, hemp seeds
Diagnostic Lab Data: 10/8/21 Ekg, Echo cardiogram, chest Xray, blood tests
CDC Split Type:

Write-up: 10/4/21 6pm Tingling sensation on soles of feet then on palms of hands ongoing high intensity for 24+hours then continuing a lower intensity on feet for 5+days; during first night sleep, whole body muscle spasms during the night causing pain which awakened from a deep sleep and resulted in body pain and fatigue upon awakening fully in the morning; 10/5/21 9am unrelenting nausea for 7 hours, non-responsive to prochlorperazine 10mg, leading to episode of vomiting at 3:00pm, then nausea responded at 7:00pm to Ondansetron 4mg; also at same time on 10/5/21 9am intense, unrelenting excruciating headache, lasting 7+ hours at a high intensity level SUD=9 (Subjective units of distress as compared up against severe migraines which untreated are SUD 7-8 and where labor pains were 9), then intermittent headaches for 5+ days; during this time 10/5/21 9-6 stillness, lying without getting up for 7 hours due to intense pain; sickly pallor about 5 hours; loss of appetite 24+hours, and low appetite for 5+days; intermittent abdominal pain, diminishing in frequency and intensity over time 5+days; 10/6/21 night - complete insomnia for 8 hours;


VAERS ID: 1775418 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BOOSTER / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: synthroid, metoprolol, micardis
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Went to CITYMD 10/09/2021 walk in close by. Said to continue what I have been doing and to drink more and more water to replace all I lost. Gave m a rapid Covid Test...Negative
CDC Split Type:

Write-up: 12 hours after injection I had a very high fever of 103 chills, sweating. Same time next night same thing high fever 103 chills sweating. For the next 3 nights, same time 8pm, severe chills fever103. at 11pm chills fever. Drenched the bed in sweat, had to change sheets and clothing several times. Same thing happened for the next two nights and same time. 6th night 8:00 and 11:00 chills and sweat. Changed bedding. Felt temperature was not as high did not take it. This is my 7th day will find out tonight what happens. Tylenol was used all times.


VAERS ID: 1775508 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA173696 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chills, Headache, Pain, Pyrexia, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No daily medications. PRN use of Tylenol for HA.
Current Illness: N/A
Preexisting Conditions: Migraine HA
Allergies: Almonds, NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 28yo Male, presenting for 1st Pfizer vaccine, presented with fever and profound body aches, HA, and chills approx 10hrs after receiving 1st dose. Pt presented to medical clinic 24hrs later for eval and tx. No red flags on exam besides tachycardia and fever. Lung CTAB, and Heart/chest exam unremarkable. Pt treated with Tylenol after eval of sx. Pt would like this documented.


VAERS ID: 1775594 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-10-01
Onset:2021-10-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Breast pain, Discomfort, Neck mass, Neck pain, Pain, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad), Arthritis (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: Ibuprofen and ice
Current Illness: None at the time of vaccination
Preexisting Conditions: Right after the vaccination I started feeling discomfort. The next day I started feeling sharp pain shooting through my breast my neck and my shoulder and arms. When I looked in the mirror the next day my neck was swollen. I had a massive lump there. I Went to the doctor and he was alarm. And he instructed me on what to do. It?s been a week now and I still have the symptoms.
Allergies: Amilopidine, losartan, lisonopril, spironactole, Eggs
Diagnostic Lab Data:
CDC Split Type:

Write-up: I experience a lot of pain, and then my shoulder and neck hurt a lot, I also experience Sharp stabbing pain. experience some pain on my breast like sharp pain starting then the next Wednesday I noticed that my neck continue hurting and Thursday I called my doctor. He and give me directions on what to do. He also said that if the symptoms don?t get better go away that I need to Get further evaluation.


VAERS ID: 1775612 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Pain, Pyrexia, Restlessness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (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: Zoloft 25mg; Flomax 0.4mg; Lipitor 10mg; Lipo Flavonoid;
Current Illness: None
Preexisting Conditions: High Cholesterol; Benign Prostate Hyperplasia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day of (MON) - soreness at injection site, achy in the evening. NIGHT OF - "Whole body Restlessness" - kept waking up having to move my body, like Restless Legs only including the torso. Day after (TUE) - soreness at injection site, 100 degree fever, fatigue. Spent most of the day in bed. 2nd day after (WED) - soreness at injection site, some fatigue. 3rd day after (THU) - mild fatigue Never had the "Whole body Restlessness" again.


VAERS ID: 1775626 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-10-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Fatigue, Pain, Paraesthesia, Skin warm
SMQs:, Severe cutaneous adverse reactions (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)

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

Write-up: PATIENT STATES SHE STARTING EXPERIENCING TINGLING IN HER ARMS (LASTING 15MINS-1HOUR) THAT COMES AND GOES, PAIN, FATIGUE, AND A FLUID-LIKE POCKET THAT IS WARM TO THE TOUCH. HER SYMPTOMS BEGAN ABOUT A WEEK AFTER RECEIVING THE SHOT AND ARE STILL ON-GOING 2 WEEKS LATER.


VAERS ID: 1775644 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-01
Onset:2021-10-04
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chest pain, Dizziness, Electrocardiogram normal, Fatigue, Laboratory test normal, Myocardial necrosis marker normal, Neck pain, Nystagmus
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: workup in the ER was fairly unrevealing with no significant lab abnormalities. No significant EKG changes. She does have nystagmus on looking to the left.
CDC Split Type:

Write-up: Patient presented my office with reports that she had been having some fatigue, lack of energy, lightheadedness since getting the vaccines 2 weeks prior to clinic visit. She had been the ER twice for complaints of chest pain radiating to the left elbow and neck. Cardiac enzymes have been undetectable in no acute ischemic changes on her EKG. Husband also had reported some nystagmus which was present on her clinical exam. She sees Dr. for her primary care


VAERS ID: 1775675 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chest pain, Dizziness, Headache, Vaccination complication
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: Patient stated he had an adverse reaction following 2 nd dose of Pfizer COVID-19 vaccine. Symptoms included headache, dizziness, abdominal discomfort, and chest pain. Patient visited ER where he was cleared and no further treatment was advised at this time.


VAERS ID: 1775715 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301558A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cheilitis, Diarrhoea, Nasal discomfort, Nausea, Pyrexia, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported the following unusual side effects: Fever $g 102 , nausea, diarrhea, sores all over lip , mouth and nose


VAERS ID: 1775722 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-01
Onset:2021-10-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swelling of upper arm (completely around arm) with pain, redness of arm, arm hot to touch, fevers, and not feeling well. Swelli
Other Medications: Glipizide, Metformin, Rosuvastatin, Lisinopril, Aspirin (low dose), Flonase, Allegra, Centrum Silver for Women (1/2 dose per day) & Super B Complex
Current Illness: None
Preexisting Conditions: Type 2 Diabetes, high blood pressure, high cholesterol, chronic tendinitis
Allergies: Ciprofloxacin Hydrochloride, Oxybutynin, Simvastatin, perfumes
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Covid Booser. Minor swelling & soreness at injection site first day, then low-grade fever 2nd day (treated with Tylenol & went away), extreme tiredness first 3 days. On 3rd day, swelling spread across upper left arm & started creeping down (included pain, redness & very warm to touch). Did not go completely around arm, but halfway around, with injection site in the middle. By 4th day, had spread down close to elbow & stopped. Swelling, pain, redness & warmth continued until 6th day, then started to subside. By 8th day, all symptoms were gone. Took Tylenol at first, but had little effect, and stopped taking it. Had very little reaction to 1st 2 Pfizer doses, with minimal swelling/pain at injection site, and some tiredness. E-appointment, which diagnosed it as Delayed Cutaneous Hypersensitivity ("COVID" arm), with no follow-up needed.


VAERS ID: 1775774 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-11
Onset:2021-10-04
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 - / SYR

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None to date. We have ac doctors appointment on Friday, 10/15.
CDC Split Type:

Write-up: On October 4th after the 2nd shot, my daughter experienced a sever allergy attack from possibly chocolate. She has never had an allergy before. It happened again on October 8th. We have now restricted her from having chocolate and we scheduled a doctors appointment for Friday to discuss with our pediatrician.


VAERS ID: 1775859 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-10-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow)

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

Write-up: Heart flutters all day long


VAERS ID: 1775878 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-10-04
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Menstruation delayed
SMQs:, Fertility disorders (broad)

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

Write-up: Late menstrual cycle after 2nd dose. Currently 7 days late. No chance of pregnancy. No treatment. Outcome is that I?m still waiting for my cycle. This is totally irregular.


VAERS ID: 1776054 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-28
Onset:2021-10-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dry mouth, Insomnia, Myalgia, Nasal congestion, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

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

Write-up: Very Sever sore throat with many follicles, nasal congestion, sever muscular pain, sever dry mouth, sleepness due to sever sore throat,


VAERS ID: 1776281 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: N/A
CDC Split Type:

Write-up: pt received expired dose of Janssen covid vaccine


VAERS ID: 1776320 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Fatigue, Feeling of body temperature change, Headache, Influenza immunisation, Mobility decreased, Nausea, Night sweats, Pain, Pyrexia, Rash, Rash erythematous, Rash pruritic, Skin wrinkling, Somnolence
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: The Pfizer ones, similar reactions but not as severe. The mixture of the shingles/pneumovax vaccine she had between the 1st a
Other Medications: Estradiol weekly, multivitamin, Vitamin D3, Brimonidine, Dorzolamide HCI-Timolol Maleate, Latanoprost Ophthalmic, calcium.
Current Illness: None.
Preexisting Conditions: Glaucoma, vascular insufficiency.
Allergies: Percocet, Morphine, Medrol dose pack, Tramadol.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: She got her vaccine, had body aches, extreme chills to the point feeling like she was in an ice bucket and then extreme heat, headache, nausea all the time, felt like she was pregnant, extreme tiredness. She could only function to eat some crackers or water. She just slept which is not her normal. She did have fever, does not know what it measured. Whatever symptoms she read about she had. She had a sunburn type rash on her chest. She woke up sopping wet on Wednesday evening, she went to the bathroom and was feeling a little better, felt that her fever broke, and noticed the sunburn type burn. At one point her temp was 101.4, but she was not able to measure other times as was too weak to get out of bed. The rash then moved down her body, from her chest/breast area to her stomach, down to her thigh area and then it went down her back and went down the upper arms on the inside, craping type skin. Then the itching started when the color went away. It was not a blotchy rash, just a red rash. This rash lasted for a couple of days. She has had this reaction before with the other vaccines but not to this extent. She has also had similar reactions to the medications that she is allergic to. She is not sure if it is a fever type rash or what, as she does get it when she gets a fever. She did also get her flu vaccine on 9/14/21, does not know which one she got, just the regular flu vaccine. There is nothing regarding the sunburn rash in the reactions section of side effects, but would like people to know this does happen. It does not blister up, it''s like a itchy blanket of sunburn.


VAERS ID: 1776344 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-10-04
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amitriptyline (ELAVIL) 25 mg oral tablet
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive COVID test 10/8/21
CDC Split Type:

Write-up: Fatigue, decreased PO intake, cough, low grade fever. "Urinating all the time"


VAERS ID: 1776370 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-10-04
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, COVID-19, Cough, Diarrhoea, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 10 mg Oral Tab aspirin-acetaminophen-caffeine (EXCEDRIN MIGRAINE) 250-250-65 mg Oral Tab aspirin-acetaminophen-caffeine (EXCEDRIN) 250-250-65 mg Oral Tab cholecalciferol, Vitamin D3, 1,000 unit oral t
Current Illness:
Preexisting Conditions: ARF (acute renal failure) (HCC) HTN (hypertension) Hyperlipidemia Pneumonia Ureteral stone Nephrolithiasis
Allergies: Codeine Morphine Pcn [Penicillins]
Diagnostic Lab Data: Positive COVID test 10/8/21
CDC Split Type:

Write-up: Weakness, loose stool, cough, ST, runny noise, loss of taste and smell.


VAERS ID: 1776380 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Condition aggravated, Confusional state, Diarrhoea, Dysarthria, Dyspnoea, Feeling hot, Formication, Headache, Hyperhidrosis, Illness, Influenza virus test negative, Metamorphopsia, Pain, Pruritus, Respiratory syncytial virus test negative, SARS-CoV-2 test negative, Urine analysis, Vomiting projectile
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Retinal disorders (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: folic acid euthyrox 75mcg.
Current Illness: none
Preexisting Conditions: none
Allergies: Eugenol
Diagnostic Lab Data: Tested on 10/4/21 for Covid,PCR, RSV, influenza, al negative. Urianalysis unremarkable. sent out for further testing.
CDC Split Type:

Write-up: I''m an RN I had NO symptoms after C-1. Only a minor frontal headache after C-2 . I got C-booster at 9:45AM MONDAY and started to feel itchy arm and heat in the car going home. Vision is distorted . My speech became slurred and disconnected from the question. I had been alternating Tylenol and Ibuprofen for the pain. Headache became so extreme on day 3 that I finally took an oxycodone . Projectile vomiting, explosive diarrhea. Mild SOB. When confusion increased the next day my daughter took me to urgent care. All the symptoms of covid but NO FEVER! My BP and pulse ox remained fairly normal until the headache became severe. Even when I was sweating profusely I never had a fever. Then I?d get chilled. Skin felt creepy like the flu makes you feel. Negative for covid, negative for flu, negative for other viruses. No source of bacteria except possible mild UTI still being investigated. So it seems likely to me that this is just a booster shot reaction. Doctor was surprised that 6 days later I was still that sick. She said I need to report the reaction to the CDC


VAERS ID: 1776422 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN EW0185 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR UJ742AB / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations: tetanus toxoid
Other Medications: acetaminophen, albuterol, aspirin, atorvastatin, dulcolax, calcium acetate, vitamin d, breo ellipts, gabapentin, hydralazine, imdur, magnesium levothyroxine, metoprolol, omeprazole, senna, tramadol, incruse ellipta, vitamin c
Current Illness:
Preexisting Conditions: malignant hypertension, hemispheric carotid artery syndrome, MI, superior mesenteric artery atherosclerosis, carotid stenosis, left bundle branch block, previous colon cancer, GER, constipation, hyperlipidemian, secondary hyperparathyroidism, lacutar infarction, dementia, asthma, back pain with spinal djd, moderate persistent asthma, chronic pain, depression, hyponatermia, anemia of chronic disease, stage 4 chronid kidney disease, microalbuminuria, bilateral retinal detachment, polypharmacy, nonintentional weight loss, b12 deficiency, vitamin d deficiency
Allergies: bactrim, amlodipine, tetanus toxoids
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncope, seizure-like activity


VAERS ID: 1776471 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-18
Onset:2021-10-04
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray normal, Differential white blood cell count normal, Electrocardiogram normal, Full blood count normal, Metabolic function test normal, Troponin normal
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: Sertraline 75mg daily Omeprazole 20 mg daily Junel 1mg-20mcg daily
Current Illness: none
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: O CBC with diff (normal) O Comprehensive Metabolic Panel POC (normal) O Troponin (POC) ISTAT performed twice (neg) O EKG Performed twice (normal) O XR Chest 2 view - pa, LAT (Normal)
CDC Split Type:

Write-up: Four days after last injection hospitalized for high blood pressure 210/110.


VAERS ID: 1776498 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Patient was originally vaccinated with the Moderna vaccine on 8/20/21 (lot 025C21A) for his first dose, and inadvertently received his second dose with the Pfizer formulation on 10/4/21. No adverse event occurred - submitting this since a vaccine administration error occurred.


VAERS ID: 1776530 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-13
Onset:2021-10-04
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

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

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

Write-up: Bell''s Palsy


VAERS ID: 1776578 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-10-04
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary, Blood albumin decreased, Blood bicarbonate decreased, Blood calcium decreased, Blood creatinine increased, Blood urea increased, COVID-19, Chest pain, Differential white blood cell count abnormal, Fibrin D dimer increased, Full blood count abnormal, Glomerular filtration rate decreased, Haematocrit decreased, Haemoglobin decreased, Lymphocyte count decreased, Mean cell haemoglobin concentration decreased, Metabolic function test abnormal, Metamyelocyte count increased, Monocyte count decreased, Pain in extremity, Platelet count decreased, Protein total decreased, Red blood cell count decreased, Red cell distribution width increased, SARS-CoV-2 test positive, Scan with contrast, Troponin T increased, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Myelodysplastic syndrome (broad), Tumour lysis syndrome (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet Acetylcysteine (N-ACETYL-L-CYSTEINE) 600 MG CAPS allopurinol (ZYLOPRIM) 100 MG tablet aspirin 81 MG enteric coated tablet atorvastatin (LIPITOR) 80 MG tablet clopidogrel (PLAVIX) 75 MG tablet Coenzyme Q
Current Illness: Gross hematuria
Preexisting Conditions: Infectious/Inflammatory COVID-19 Nervous Acute neck pain Genitourinary Stage 3b chronic kidney disease
Allergies: No Known Allergies
Diagnostic Lab Data: Labs: Labs Reviewed HIGH SENSITIVITY TROPONIN T BASELINE - Abnormal; Notable for the following components: Result Value Ref Range Status hsTnT Baseline 36 (*) <22 ng/L Final hsTnT Interpretation Indeterminate (*) Normal Final Comment: Please see algorithm to guide Troponin evaluation. There are a variety of reasons Troponin may be elevated, including: - Coronary artery disease with atherosclerotic plaque disruption / thrombosis (Type-1 MI: STEMI or NSTEMI) - Oxygen Supply/Demand mismatch causing ischemia (Type-2 MI.) (e.g. tachyarrhythmia, hypertension, anemia) - Other conditions causing myocardial injury (e.g. CHF, myocarditis, renal failure, sepsis) Please correlate with the clinical presentation and ensure documentation is consistent with the nature of the Troponin elevation. Interpretation: Normal: Females <14 ng/L; Males <22 ng/L Indeterminate: Females 14-99 ng/L; Males 22-99 ng/L Critical: $g= 100 ng/L **Anticipate admission and consult the appropriate service - If symptoms are present for <3 hours and initial troponin is normal or indeterminate, repeat in 2hrs - For a HsTn level < 100ng/L, if there is a change of $g= 8ng/L, this is abnormal; consider cardiology guidance for possible admission/observation. - For a HsTn level $g=100 ng/L, if there is a change of $g=20%, this is significant; consider cardiology guidance for possible admission/observation. - If the initial troponin is normal and symptoms present for $g3 hours or if repeat troponin delta is <= 8ng/L, myocardial infarction is unlikely. For ED patients, consider HEART Score to determine level of follow-up needed. All other components within normal limits COMPLETE BLOOD COUNT (CBC) W/DIFFERENTIAL - Abnormal; Notable for the following components: Red Blood Cell 3.87 (*) 4.60 - 6.00 x10*6/uL Final Hemoglobin 10.9 (*) 14.0 - 18.0 g/dL Final Hematocrit 34.3 (*) 42.0 - 52.0 % Final Mean Cell Hemoglobin Concentration 31.8 (*) 32.0 - 37.0 g/dL Final Red Cell Diameter Width 16.7 (*) 11.0 - 16.0 % Final Platelet 124 (*) 140 - 400 x10*3/uL Final All other components within normal limits COMPREHENSIVE METABOLIC PANEL - Abnormal; Notable for the following components: HCO3 19 (*) 21 - 29 mmol/L Final Blood Urea Nitrogen 34 (*) 8 - 20 mg/dL Final Creatinine 1.47 (*) 0.60 - 1.30 mg/dL Final MDRD eGFR 45 (*) $g=60 mL/min/1.73 m2 Final Comment: MDRD GFR calculation is based on the 4 value MDRD equation. K/DOQI Clinical Practice Guidelines for chronic kidney disease. Part 5 Guideline 5 MDRD estimated GFR (eGFR) is best used for detection of chronic kidney disease in clinically stable patients. DO NOT USE VALUES FROM THIS EQUATION FOR DRUG DOSING. It has not yet been validated for drug dosing or for patients with rapidly changing clinical situations (inpatient care). The calculated GFR is gender, age, and race specific. Values for patients identified are calculated using the equation. Calcium Level Total 8.2 (*) 8.6 - 10.4 mg/dL Final Protein Total 5.7 (*) 6.0 - 8.0 g/dL Final Albumin Level 2.6 (*) 3.5 - 5.0 g/dL Final All other components within normal limits D-DIMER,QUANTITATIVE - Abnormal; Notable for the following components: D-Dimer Quant 1,330 (*) 0 - 500 ng/mL FEU Final Comment: It should be noted that the published studies evaluating this assay have included only Emergency Room or other outpatients presenting with new symptoms suggestive of thromboembolic disease. This assay has not been evaluated for this purpose in hospital inpatients, postoperative patients, or other patient types than those indicated. Elevated D-Dimers may be seen in activation states of coagulation. Elevated states of D-Dimer levels may be associated with the following: DVT, DIC, hemorrhages, fibrinolysis, post-operative periods, cancer, and severe infections. D-Dimer levels may be falsely elevated in underlying, non-thrombotic conditions common in hospitalized patients. Cut-off value for D-dimer use in evaluation of VTE is 500 ng/mL FEU. The measurement of D-Dimer should not be used as an aid in the diagnosis of VTE in patients with: - Therapeutic dose anticoagulant therapy for $g24 hours - Fibrinolytic therapy within previous 7 days - Trauma or surgery within previous 4 weeks - Aortic aneurysm - Sepsis, severe infections, pneumonia, severe skin infections - Liver cirrhosis - Renal Failure - Pregnancy Physicians recommend that in patients older than 50 years with low-to-intermediate pretest probability for acute pulmonary embolism, an age-adjusted D-dimer cutoff of age x 10 (FEU units) can be used to exclude a diagnosis of PE without need for further imaging. Med.2015;163:701-711 Blood Adv 2018;2:3226 All other components within normal limits DIFFERENTIAL, MANUAL BLOOD - Abnormal; Notable for the following components: Bands Manual 31 (*) 0 - 10 % Final Lymphocytes Manual 4 (*) 20 - 50 % Final Monocytes Manual 1 (*) 2 - 12 % Final Metamyelocyte Manual 5 (*) <=0 % Final All other components within normal limits POCT ISTAT CREA CARTRIDGE - Abnormal; Notable for the following components: Creatinine 1.60 (*) 0.60 - 1.30 mg/dL Final MDRD eGFR 40.37 (*) $g=60.00 mL/min/1.73 m2 Final All other components within normal limits Narrative: HIGH SENSITIVITY TROPONIN T 2 HOUR Imaging: CT ANGIO THORAX WITH IV CONTRAST (Results Pending)
CDC Split Type:

Write-up: A 95-year-old male with past medical history of hypothyroidism who presents today with chest pain. Patient states that chest pain began at 10pm when he was lying in bed. Patient called EMS at this time and was brought in. Chest pain initially had improved but when I entered the room, he noted having his chest pain returning. Patient states that it is left-sided and noted to be deep. Pain involves the left arm at this time. He denies pain in the left chest wall. He has been to the emergency department 4 times in the last 3 months due to this chest pain. He states that the chest pain always goes away by the next day. He has no prior cardiac history. He had a positive COVID test on 10/1/2021. The patient notes that he is vaccinated for COVID-19 and is unsure of how he got infected. patient has no other questions or concerns at this time.


VAERS ID: 1776598 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cold sweat, Headache, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Slynd 4mg daily Ropinirole 1 mg QHS daily multivitamin Sertraline 50 mg QHS
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Generally ill feeling. body aches, chills, cold sweat, headache, slight fever.


VAERS ID: 1776666 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chills, Confusional state, Diarrhoea, Dizziness, Fatigue, Flushing, Headache, Hyperhidrosis, Insomnia, Nausea, Pain, Palpitations, Pyrexia, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Abdominal Pain-Medium, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Medium, Systemic: Diarrhea-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Fever-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Nausea-Medium, Systemic: Unable to Sleep-Severe, Additional Details: Severe Palpitation


VAERS ID: 1776727 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Condition aggravated, Pain in extremity, Product storage error
SMQs:, Tendinopathies and ligament disorders (broad), 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None at this time. Will have titer drawn at 14 days post vaccine.
CDC Split Type:

Write-up: Person was administered vaccine dose that was given 81 minutes after the 6 hour time frame. No adverse event reported from patient at this time. Had normal reaction, sore arm, that occurred with first two doses.


VAERS ID: 1776735 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-29
Onset:2021-10-04
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, COVID-19, Chest X-ray, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily medications
Current Illness: No
Preexisting Conditions: High blood pressure
Allergies: No
Diagnostic Lab Data: COVID test blood work X-ray of lungs
CDC Split Type: vsafe

Write-up: Had an outbreak of COVID virus after being fully vaccinated. On 10/05/2021 I got the antibody infusion.


VAERS ID: 1776739 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, Immune-mediated adverse reaction, Lymphadenopathy
SMQs:, Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: None
CDC Split Type:

Write-up: Was given Pfizer BioNtech vaccine 67 minutes after expiration time. Had robust immune response with swollen axilla lymph nodes on side of immunization.


VAERS ID: 1776759 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, Immunisation reaction, Malaise
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: Was given Pfizer BioNtech vaccine 78 minutes after expiration time. Had the same reaction has she had to two previous vaccines.
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: unknown
Diagnostic Lab Data: None. will have antibody''s tested 14 days after administration
CDC Split Type:

Write-up: Was given Pfizer BioNtech vaccine 78 minutes after expiration time. Denied any adverse reaction after administration. Had slight immune response, didn''t feel well.


VAERS ID: 1776778 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, Malaise
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: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None. will have antibodies tested 14 days after administration
CDC Split Type:

Write-up: Was given Pfizer BioNtech vaccine 81 minutes after expiration time. When called states she did not feel well for 1-2 days after vaccine administration.


VAERS ID: 1776783 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / IM

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

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

Write-up: Pfizer Covid-19 vaccine booster dose administered around 90 beyond syringe expiration time (i.e., past the 6 hour window after vaccine mixed).


VAERS ID: 1776802 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / IM

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

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

Write-up: Pfizer Covid-19 vaccine booster dose administered around 90 minutes beyond syringe expiration time of 11:30am (i.e., after 6 hours from mixing vaccine).


VAERS ID: 1776809 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / IM

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

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

Write-up: Pfizer Covid-19 vaccine booster dose administered around 90 minutes beyond syringe expiration time of 11:30am (ie, over 6 hrs after vaccine mixed).


VAERS ID: 1776816 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / IM

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

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

Write-up: Pfizer Covid-19 vaccine booster dose administered around 90 minutes beyond syringe expiration time of 11:30am (i.e., over 6 hours after vaccine was mixed).


VAERS ID: 1776828 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-02
Onset:2021-10-04
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10/8 Positive COVID test.
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1776859 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-10-04
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: fever, headache, cough


VAERS ID: 1776880 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-01
Onset:2021-10-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D 1000 IU by mouth daily
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None thus far. Plan is to schedule consult with allergist/immunologist to discuss above and have evaluation of ongoing urticarial rash.
CDC Split Type:

Write-up: Pfizer booster administered on 10/1/21 (9 mos post 2nd Pfizer vaccine) without issue. No adverse side effect from 1st or 2nd doses Pfizer. Felt significant body aches fatigue ~12 hours post booster into following day. Not a big concern though did not have this from either 1st, 2nd dose. 2 days post booster broke out with significant urticarial rash posterior L leg, few hives on R leg and torso. Extreme pruritus area of urticaria. Some extension of rash area over next couple days. Rash has not resolved, but is stable 10 days post booster. Few scattered, isolated hives have appeared on legs over the week since initial rash outbreak. Flare ups typical of histamine response when hot, or any increased blood flow to area. OTC Zyrtec 10 mg PO taken most days since outbreak helpful for itching, discomfort. Triamcinolone cream applied topically to rash somewhat helpful too.


VAERS ID: 1776919 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-10-04
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lhermitte's sign, Multiple sclerosis
SMQs:, Optic nerve disorders (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: I am experiencing what is known as Lhemeritte''s Sign. It is a common MS symptom, but I have never experienced it until now. In fact, I was displaying no MS symptoms for years.


VAERS ID: 1776958 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 UN / IM

Administered by: Work       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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: covid booster vaccine given 60 minutes after expired time


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