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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 392 out of 8,010

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VAERS ID: 1637334 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

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

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

Write-up: Pt showed no adverse side effects. Was administered to a patient under the age of 18 years old.


VAERS ID: 1637361 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Chest pain, Electrocardiogram normal, Laboratory test normal
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone,Larin,Zyrtec,vitamins D,C,zinc and iron
Current Illness: URI (non-covid) 3.5 weeks prior
Preexisting Conditions: PC IS, environmental allergies
Allergies: None
Diagnostic Lab Data: Ekg, chest xray, labs
CDC Split Type:

Write-up: 10 minutes after receiving the vaccine, I started to experience squeezing/pressure in my mid-chest under my sternum. I tried to attribute it to anxiety but after 1 hour of symptoms, I returned to the vaccine clinic site. They monitored my vitals which were stable. I returned to work thinking if I could keep my mind off of it, the sensation would go away. It didn''t. 10 hours later, I was still experiencing chest pain. I went to a local ED and had a full work up including EKG, chest xray and labs. Nothing concerning was found. I am still having chest pain today.


VAERS ID: 1637366 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-01
Onset:2021-08-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8848 / 7+ RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Condition aggravated, Dyspepsia, Dyspnoea, Feeling hot, Limb discomfort, Migraine, Mobility decreased, Pain in extremity, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Peripheral neuropathy (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Breathing problems when younger rashes when a child
Other Medications: Levadopa/ Carbadopa Albuterol Symbicort
Current Illness: None
Preexisting Conditions: Parkinsons, asthma, osteoarthritis, psoriasic arthritis
Allergies: Neyomyicin , eggs, chocolate
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Worse asthma, feeling breathless. Tingling arm still after 24 hrs. Hot feeling spine. Severe migraine headache. Heavy painful useless right arm. Heartburn


VAERS ID: 1637368 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Feeling jittery, Palpitations, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient waited for 15min after the vaccine in the pharmacy waiting area. After 15 min patient left pharmacy and returned back from outside stating "she has thigh throat, shortness of breath. and hive. We administered Epi Pen right thigh. After Epi she has jitteriness and racing heart. We called 911 and monitor patient until paramedics arrive. Patient decline emergency care. Left pharmacy in a stable state. I make a follow up phone call on 08/26/21 and left a message.


VAERS ID: 1637387 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Dizziness, Dyspnoea, Feeling abnormal, Head discomfort, Immediate post-injection reaction, Ocular hyperaemia, Somnolence, Swollen tongue, Tremor, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), 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), Glaucoma (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Client reported feeling dizzy immediately after administration of the COVID vaccine Janssen. Noted the client was rubbing his forehead and eyes. The client''s eyes were closed. When the client opened his eyes. Noted the client''s eyes appeared red. Noted that this redness was not present prior to receiving the vaccine. The client was deliberately shaking his hands bilaterally and squeezing his hands into fists. Asked the client what his current symptoms were and he did not verbally respond. Repeated the question. A few seconds later the client stated he felt "dizzy and weird." The client stated that he felt something in his right leg, but RN was unable to discern what the client said. RN noted shaking of the client''s right leg. The client stood up with the assistance of his cane and support of the arm of the anti-gravity chair and transferred into the anti-gravity chair. The client appeared unsteady on his feet to RN. The anti-gravity chair was reclined. The client was verbally unresponsive for a few seconds. RN noted the client''s head leaned against the anti-gravity chair and the client''s eyes were closed. The client then opened his eyes. The client was alert and oriented to person, place, and time. The client reported feeling "dizzy, weak, and sleepy, like when you have surgery." The client denied any chest pain or shortness of breath. Vitals obtained at 1:39PM were as follows: BP 147/94 and HR 84. The client stated he felt thirsty, RN offered the client water. The client did not drink the water. At 1:43PM the client reported "my tongue feels like when you take medicine." The client subsequently clarified that his tongue felt "swollen." RN assessed the client''s tongue and did not note any swelling and noted the client''s tongue was pink. The client has a history of seizures and takes Dilantin. The client states he took his Dilantin this morning as prescribed. The client stated his current status feels different than his seizures. The client states that when he has a seizure he "shakes a lot and then I can''t talk." Vitals obtained at 1:46PM were as follows: BP 134/90 and HR 90. The client stated that his tongue still felt "swollen." The client stated that he took the trolley to the vaccination site and does not have anyone who could come and pick him up. The client stated his throat felt "itchy." Offered the client Diphenhydramine IM. The client reported a history of an allergy to Keppra where he developed a rash. The client denied any history of anaphylaxis. Oxygenation status obtained via pulse oximeter at 1:52PM was 97%. The client stated that he would like to receive Diphenhydramine IM. RN educated the client regarding Diphenhydramine including risk of drowsiness. The client voiced understanding of this education and gave verbal consent to receive Diphenhydramine IM. The client stated his dizziness was improving and that he still felt tired at 1:52PM. RN administered 50mg/1ml Diphenhydramine (Lot# 020020 exp 02/2022) in the right deltoid muscle at 1:53PM. The client was verbally non-responsive for a several seconds after receiving the Diphenhydramine. RN noted shaking of the client''s right leg. The client''s head was heavy on the anti-gravity chair. The client then attempted to sit up quickly. RNs reassured the client of the situation and the client relaxed in the chair. RN activated EMS at 1:55PM. The client stated "I can''t breathe". RN noted the client clutching his chest. The client reported repeated difficulty with respirations. Prepared to administer Ephinephrine by removing the cap and safety release. RN prepared to administer the Epinephrine when the client moved quickly and stated "no." RN did not administer Ephinephrine. RN educated the client regarding Ephinephrine and continued to question the client regarding his respiratory symptoms. The client appeared more alert to RN and began to respond to questions more clearly. RN noted no pallor or use of accessory muscles. The client stated that his breathing was improving. Vitals obtained at 2:00PM were as follows: BP 146/88 and HR 84. The client denied any persistent weakness. The client appeared disoriented to RN. The client stated that his right arm hurt. RN explained that was likely related to the Diphenhydramine administered IM into the right deltoid. The client asked RN, "I received another injection?" RNs educated the client regarding the administration of Diphenhydramine IM. The client voiced understanding of this education. EMS assumed care at approximately 2:03 PM. The client was transported to ER 2:09PM.


VAERS ID: 1637389 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Pyrexia, SARS-CoV-2 test negative
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin 150 mg 1x/day, unithroid 112 mcg 1x/day, Claritin 1x/day, Xgeva shot ever 6 weeks
Current Illness: none. I also had a fever/body aches/fatigue starting 20 hours after this vaccination and lasting about 24 hours. This was my 3rd prime shot.
Preexisting Conditions: metastatic lung cancer. Was treated with Keytruda and pemetrexed at the time of my first 2 Pfizer vaccines on 2/4/21 and 2/24/21. 5/4/21 was my last treatment.
Allergies: dust mites, dust
Diagnostic Lab Data: BinaxNow home Covid test at 10pm 8/25/21. Result: negative
CDC Split Type:

Write-up: I had fever/chills/exhaustion/loss of appetite starting at about 20 hours after the shot. This was my 3rd shot, as I''m considered immunocompromised because I was under treatment for cancer with pemetrexed and Keytruda at the time of shots #1 and #2 (2/4/21 and 2/25/21). Those resolved as expected in about 24 hours and were improved with Advidl. 6 days after the shot, I got a fever of 100.5/fatigue/loss of appetite again and it''s lasted now about 24 hours. It''s milder than 20 hours after the shot, but I thought it was strange to have that 6 days after the Pfizer #3. I thought it would be useful for VAERS to track delayed reactions like this.


VAERS ID: 1637390 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Skin tightness
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: Effexor, Wellbutrin, ibprofen,multi-vitamin,vicks zzz quil, nmn, vitamin D, green coffee bean extract.
Current Illness: None.
Preexisting Conditions: Anxiety, depression.
Allergies: Allergic to flonaise and other similar steroids, living cows.
Diagnostic Lab Data: None. Have not reached out for medical assistance at this time. Will continue to monitor and if continues to worsen, will seek medical attention. This was my second shot, I had no issue with the first shot.
CDC Split Type:

Write-up: Large red swollen place at site of injection (about the size of a half dollar). It began as the usual post-injection side effect. Two days later I noticed it was more red and had risen. Since then it has gotten bigger. Also have burning and slight itch as well as tightness around the arm near injection site.


VAERS ID: 1637400 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Hypoaesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient complained about having a numbness sensation to her tongue, and anxious, no other complains of symptoms. Vital signs were taken. Patient refused benadryl and stated to have felt better at 1415.


VAERS ID: 1637402 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Dizziness, Hyperhidrosis, Immediate post-injection reaction, Loss of consciousness, Malaise, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: COVID19 FIRST-DOSE PFIZER VACCINE 345PP ADMINISTERED IN LEFT DELTOID, AND PATIENT STATED DISCOMFORT AFTER ADMINISTRATION. SHORTLY AFTERWARDS (WITHIN 15 SECONDS), PATIENT STATED FEELING DIZZY AND NOT WELL. SOON AFTERWARDS PATIENT LOST CONCIOUSNESS WHILE IN THE ADMINISTRATION CHAIR AND PROCEEDED TO SLOPE, REQUIRING THAT THE PATIENTS HEAD BE MANUALLY SUPPORTED. PATIENT DID NOT HIT THE FLOOR, BUT WITHIN 5 TO 10 SECONDS, THE PATIENT RETURNED TO CONCIOUSNESS. EMERGENCY SERVICES WAS THEN IMMEDIATELY REQUESTED TO BE CALLED. PATIENT LOOKED PALE AND WAS VISIBILY SWEATING AFTER FAINTING. PATIENT DENIES BREATHING ISSUES AT THE TIME, AND IT DID NOT APPEAR THAT THE PATIENT WAS BREAKING OUT IN HIVES, THEREFORE EPIPEN WAS NOT NECESSARY. AMBULATORY SERVICES ARRIVED WITHIN FIVE MINUTES AND TOOK OVER. PATIENT WAS ADVISED TO REMAIN IN THE FETAL POSITION UNTIL A STRETCHER COULD BE BROUGHT, WHEREBY EVENTUALLY PATIENT WAS ESCORTED OUT OF THE BUILDING IN A STRETCHER. THE PATIENT WAS CALLED A DAY LATER AND REPORTED FEELING FINE.


VAERS ID: 1637410 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

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

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

Write-up: Hives on bilateral arms, legs, chest, and back


VAERS ID: 1637590 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Palpitations, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported sensation of throat closure and palpitations. Patient has history of A-fib and stroke. Patient given 50 mg of benadryl IM and improved until stable and discharged from facility.


VAERS ID: 1637611 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Chest pain, Rhabdomyolysis, Troponin
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: olanzapine 2.5mg daily
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: 8/25/21 @1710: CK 6177; Troponin <0.01 8/25/21 @1906: CK 6022 8/26/21 @0648: CK 7016
CDC Split Type:

Write-up: 15yo M w hx depression presenting w chest pain found to have rhabdomyolysis


VAERS ID: 1637618 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Disorientation, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1000mg EPA
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Iodine, Melon, Bananas
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Shortly after receiving the shot I got in my car to ride home and lost consciousness for about 45 seconds. When I came to there was unbearable pressure in my chest and I reminded disoriented for about 2 minutes. My chest pain didn?t subside for about 15 minutes. I went to the ER, but left after waiting for an hour and a half and I had started to feel better.


VAERS ID: 1637621 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Cardiac flutter, Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (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: heart fluttering, heart pain, chest pain, and troubled breathing


VAERS ID: 1637633 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Lymph node pain, Lymphadenopathy, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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: Chicken Pox Vaccine 1999
Other Medications: Prednisone Humira Methotrexate Vitamin D Folic Acid Loestrin Valtrex Pepcid Zyrtec
Current Illness:
Preexisting Conditions: Genital Herpes Rheumatoid Arthritis
Allergies: Pineapple Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nauseau - 5 am 8-25 Dizziness - Ongoing for 48 hours Left armpit lymph node swollen and painful to touch - ongoing for 48 hours


VAERS ID: 1637637 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Paraesthesia, Paraesthesia oral, Tongue disorder, Tongue dry
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None stated
Current Illness: None stated
Preexisting Conditions: None stated
Allergies: Client denied any allergies to medications, food or other products
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Client stated her face and tongue felt, "tingling and thick" within 5 minutes of receiving a Pfizer COVID vaccine (LOT FC3183) in the left deltoid intramuscularly. Lead RN made contact with client who was in no apparent respiratory distress and had a calm demeanor, she stated her tongue felt thick and dry. Skins were warm, dry and normal color for ethnicity. Client denied any shortness of breath (SOB), chest pain (CP), difficulty breathing, dizziness or HA. She stated she otherwise felt fine and denied having any difficulty swallowing and was able swallow sips of water without difficulty or incidence, client was speaking coherently without any slurred or affected speech. A first set of vitals were taken at 1447: BP 120/70, HR: 68, RR 20. Client denied any pertinent medical history, denied any allergies to medications/foods/environment. Client denied any history of anaphylaxis and stated the feeling was similar to "being at the dentist with anesthesia". At 1449 client was given 50mg oral Diphenhydramine. Client continued to be calm and in no apparent distress other than stating her mouth and face were tingling. Client continued to be able to converse coherently and without affect. At 1456 client ambulated to the zero gravity chair without incidence and a second set of vitals were taken: BP 110/72, HR: 62, RR: 18, skins warm, dry and normal color. Client continued to deny any other symptoms such as SOB, CP, difficulty breathing, dizziness or HA. Client stated symptoms of thick tongue and tingling were not worsening. She continued to speak coherently without slurred or affected speech. EMS was activated at 1457. At 1503 care transferred to EMS. Client continued to deny any progression of symptoms, she stated the tingling of mouth and tongue continued and were "not worsening or getting better". EMS advised client to go to ER by medical transport. Client expressed concern regarding not having health insurance. EMS convinced client to go to the ER. Client agreed and ambulated to EMS gurney chair without incidence. She remained in no apparent respiratory distress, skins were normal for ethnicity, client continued to speak clearly. At 1510 client was taken to ER by EMS transport.


VAERS ID: 1637816 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Chills, Diarrhoea, Fatigue, Feeling abnormal, Impaired work ability, Poor quality sleep
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient reported feeling okay after getting the vaccination, went to bed, didn''t sleep well, awoke for on 08/25/21 at 0600, felt "strange", went to work then had to come home early because he was extremely tired. Patient developed Temp of 103 F, took fever reducer with no change in Temp until today, Temp = 101.3, chills of f and on, diarrhea began today 08/26/21 with patient having several very loos stools prior to calling our office at 4:21 PM.


VAERS ID: 1637825 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Arthralgia, Chest pain, Extra dose administered, Pleuritic pain, Pulmonary embolism, Ultrasound Doppler normal
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Medication errors (narrow), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol prn
Current Illness: none
Preexisting Conditions: mild asthma
Allergies: ciprofloxacin
Diagnostic Lab Data: CTA chest with bilateral segmental and subsegmental PEs on 8/26 LE duplex without DVTs on 8/26
CDC Split Type:

Write-up: In the 24hrs after receiving 3rd dose in an immunocompetent patient, patient developed L shoulder pain (received dose in L upper arm) and then developed L pleuritic chest pain. Found to have bilateral segmental and subsegmental non-massive pulmonary embolism, improving with heparin and transition to eliquis. No evidence of DVT.


VAERS ID: 1637831 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / SYR

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

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

Write-up: Sore arm, body aches, 100 degree fever, tired


VAERS ID: 1637837 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphonia, Arthralgia, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Lost voice, swelling right arm, fever, joint pain


VAERS ID: 1637843 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

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

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

Write-up: After the injection roughly 2 minutes I got light headed and passed out. I was woke up by the nurses after being unresponsive for approx 30-40 seconds. My blood pressure was around 100/40, and my pulse was around 36. The numbers may be off a bit but I was still waking up and can''t remember the exact numbers. The numbers should be wrote down by the nursing staff and filed. They watched me for 30 minutes and let me go. Today on 8/26/2021 my stomach hurts and I have pressure in my chest. I think I''m just constipated so I am trying to take care of that. If it doesn''t work and I still feel this way after I pass a stool, I will go to a hospital. To be safe.


VAERS ID: 1637845 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Dizziness, Headache, Hot flush, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Throbbing headache, chills, stabbing lower back pain, hot flashes, dizziness, lightheaded when standing, syncope when standing


VAERS ID: 1637858 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-19
Onset:2021-08-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Computerised tomogram thorax, Fibrin D dimer increased, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased
SMQs:, Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium carbonate, carvedilol, gabapentin, hydralazine, Percocet, losartan, pantoprazole, ropinirole,
Current Illness: None
Preexisting Conditions: nonischemic cardiomyopathy diagnosed 7/2020 (possible LV noncompaction), granulomatosis with polyangiitis, end-stage renal disease on hemodialysis MWF, chronic left bundle branch block, hypertension, hyperlipidemia
Allergies: Augmentin, mupirocin
Diagnostic Lab Data: Elevated ESR 36 mm/h, elevated CRP 5.7 mg/dL, elevated D-dimer 0.94 mcg FEU/mL. CT pulmonary angiogram showing small pericardial effusion. All above tests performed 8/26/2021. Anticipate transthoracic echocardiogram 8/27/2021.
CDC Split Type:

Write-up: Acute Pericarditis


VAERS ID: 1638049 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Headache, Injection site discomfort, Injection site erythema, Injection site pain, Injection site rash, Injection site warmth, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: (DOB 10/21/1962) - received second Moderna COVID-19 vaccine on 8/24/2021. Pt came to the pharmacy on the evening of 8/25/2021 to let the pharmacist look at a red rash at the right arm injection site of the second vaccine dose. The area was red and she said it was hot to the touch and sore to the touch. She was advised to take Tylenol and use a cold compress to help with the discomfort. She was also experiencing low grade fever, headache and general malaise. On 8/26/2021, Pt returned to the pharmacy to let the pharmacist look at the injection site. On 8/26/2021, the red area had increased in size moving both up and down the arm and expanding toward the inner and outer portions of the upper arm. She stated the muscle was also very sore. Pt was advised to take Tylenol, apply a cold compress and monitor for additional spreading of the red area. She was advised that if the area did not improve, she should seek medical attention.


VAERS ID: 1638052 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Diarrhoea, Dizziness, Erythema, Palpitations, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B, Vitamin C, Zinc, Pepcid, Corig, Lisinopril, Omega 3
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, swelling, joint pain, diarrhea, dizzy, palpitations


VAERS ID: 1638058 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

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

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

Write-up: Muscle pain in arm, severe fatigue.


VAERS ID: 1638248 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Headache, Pain, Pyrexia, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Body ache, chills fever, headache, chest tightness, sneezing


VAERS ID: 1638250 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Ear pain, Menstrual disorder, Polymenorrhoea, Respiratory tract congestion, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Annual flu shot, chills and body aches
Other Medications: N/a
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Throat ulcer, mild congestion and ear pain, early arrival of period following vaccination, significantly heavier period and increased cramps


VAERS ID: 1638258 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cardiac function test normal, Cold sweat, Hypoaesthesia, Movement disorder, Nausea, Nervousness, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Hydrocodone
Diagnostic Lab Data: Blood pressure, heart, and oxygen levels were measured at health department. All levels in normal range. Tried to call doctor the day after vaccine but did. It recieve a call back from doctor.
CDC Split Type:

Write-up: Became nauseous and clammy after getting shot. Hands and arms became numb and I was unable to move my hands. About 5 minutes later the numbness went away. Vitals during this episode were normal. Health department workers were not concerned and told me it was due to me being nervous. The day after the vaccine I became nauseous again. Left arm was shaking violently and numb. Lasted about 1 1/2 hours. Shaking decreased but is still observed. My family doctor was called but I did not receive a call back.


VAERS ID: 1638429 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Formication, Hypoaesthesia, Pain in extremity, Pain of skin, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: 8/25/2021 started with tingling in feet then toes were numb. Then left leg started tingling and hurt. Then finger tips were tingling. Then right leg started tingling. 8/26/2021 both leg are tingling like they are going to sleep. Tingling feeling in my neck, back of my head, and up my back. My chest feels like my heart is beating fast. I feel like there is something crawling under my skin or a sharp zapping pain. I haven''t went to the doctor yet. I was trying to wait it out but this is not going away.


VAERS ID: 1638441 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Skin discolouration, Vitiligo
SMQs:, Hypotonic-hyporesponsive episode (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: none that day
Current Illness:
Preexisting Conditions:
Allergies: penicillin, cipro, shellfish, codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: developed skin discoloration - vitiligo on arms and legs


VAERS ID: 1638925 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210851598

Write-up: SORENESS AND ACHINESS; HIGH FEVER; HEADACHES; 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, batch number: Unknown) dose was not reported, administered on 25-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 25-AUG-2021, the patient experienced soreness and achiness. On 25-AUG-2021, the patient experienced high fever. On 25-AUG-2021, the patient experienced headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the high fever, soreness and achiness and headaches was not reported. This report was non-serious.


VAERS ID: 1638931 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Off label use, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210851704

Write-up: DRUG ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 YEAR OLD); OFF LABEL USE; This spontaneous report received from a health care professional concerned a 17 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820095, expiry: UNKNOWN) dose was not reported, administered on 25-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-AUG-2021, the patient experienced drug administered to patient of inappropriate age (17 year old). On 25-AUG-2021, the patient experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the drug administered to patient of inappropriate age (17 year old) and off label use was not reported. This report was non-serious.


VAERS ID: 1638932 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, Off label use
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: USJNJFOC20210851724

Write-up: ADMINISTERED THE JANSSEN COVID-19 VACCINE TO A FEMALE PATIENT AND GAVE HER THE ENTIRE VIAL; OFF LABEL USE; This spontaneous report received from a health care professional concerned an adult female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 204A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 25-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-AUG-2021, the patient experienced administered the janssen covid-19 vaccine to a female patient and gave her the entire vial. On 25-AUG-2021, the patient experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administered the janssen covid-19 vaccine to a female patient and gave her the entire vial and off label use was not reported. This report was non-serious.


VAERS ID: 1638942 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: South Dakota  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 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: USJNJFOC20210852160

Write-up: ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a pharmacist concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1805029 expiry: 23-AUG-2021) dose was not reported, administered on 25-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-AUG-2021, the patient experienced administration of expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administration of expired vaccine was not reported. This report was non-serious.


VAERS ID: 1638945 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
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: USJNJFOC20210853046

Write-up: EXPIRED VACCINE ADMINISTERED/ DOSE WAS DRAWN ON 24-AUG-2021 11:00 AND ADMINISTERED ON 25-AUG-2021 13:00; This spontaneous report received from a health care professional concerned a 29 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: 21-SEP-2021) dose was not reported, administered on 25-AUG-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 25-AUG-2021, the patient experienced expired vaccine administered/ dose was drawn on 24-aug-2021 11:00 and administered on 25-aug-2021 13:00. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired vaccine administered/ dose was drawn on 24-aug-2021 11:00 and administered on 25-aug-2021 13:00 was not reported. This report was non-serious.


VAERS ID: 1640722 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Headache, Hyperhidrosis, Hyperventilation, Nausea, Panic attack, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Mild, Systemic: Hyperventilation-Medium, Systemic: Nausea-Mild, Systemic: Shakiness-Medium, Additional Details: pt was expericing a panic attack after the vaccine. pt started hyperventilating and sweating profusely. pt requested that i call 911. Ambulance came and all vitals were normal. ambulance refused transport. pt sat at the pharmacy for another 15 mins. followed up with pt 5-6 hours later. pt was doing well. no other signs or symptoms


VAERS ID: 1640730 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

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

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

Write-up: Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Tingling (specify: facial area, extremities)-Mild, Additional Details: Tingling, pin pick, numb feeling in right arm/hand


VAERS ID: 1640741 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Discomfort, Dizziness, Fall, Hyperacusis, Hyperhidrosis, Muscular weakness, Myalgia, Photophobia, Pyrexia, Seizure, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Accidents and injuries (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin-daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 8/25 7:00pm- severe muscle pains in whole body. 7:30pm- severe body tremors/convulsions started (lasted 3 hours) followed by chills, fever, sweating. 8/26 9:00am severe dizziness, lightheaded, severe sensitivity to light and sound. Lasted all day 8/27 12:30am got up to go to the bath room and my right leg felt funny, went to take a step and it completely gave out on me and I fell. I tried to get up and it wouldn?t work, it could t hold weight. I had to sit for 3/4 minutes before I could use it again. 6:30 am- now? my body is extremely heavy.


VAERS ID: 1640954 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 9399901 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Cardiac flutter, Chest X-ray, Chest pain, Chills, Dehydration, Dizziness, Dyspnoea, Electrocardiogram, Gaze palsy, Hypersensitivity, Nausea, Oropharyngeal pain, Pain, Palpitations, Pyrexia, Swelling face, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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

Write-up: Patient began experiencing severe adverse symtpoms on 8/25/2021 at 2am. She went to the ER and they gave her some IVs, Benedryl, pain meds, chest X-ray, ekg. Side effects reported: Fever SOB/Trouble breathing Chest Pain Sore Throat Headache Body Aches Joint pain Vomiting Nausea Dehydration Allergic Reaction/Swollen Face Feelings of having a fast-beating, fluttering, or pounding heart Chills Dizziness Weakness


VAERS ID: 1640979 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 RA / IM

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

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

Write-up: Swollen and painful lymph-nodes in the right breast and arm pit. Pain level of 5/10 mostly a constant dull ache with an occasional sharp 10/10 pain.


VAERS ID: 1640985 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Oropharyngeal pain, Pain, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: MULTIVITAMIN, ZINC, VITAMIN D, CALCIUM AND VITAMIN C
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: ZITHROMAX, LATEX
Diagnostic Lab Data: none
CDC Split Type:

Write-up: sore throat, runny nose, headache, tired, achy


VAERS ID: 1640990 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein, Chest X-ray, Chest pain, Chills, Diarrhoea, Electrocardiogram, Fibrin D dimer, Full blood count, Metabolic function test, Nausea, Pyrexia, Red blood cell sedimentation rate, Retching, Troponin
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none known
Preexisting Conditions: depression, exercise induces asthma, menorrhagia, patellofemoral stress syndrome,
Allergies: gentamicin
Diagnostic Lab Data: chest xray, ekg, troponin, crp, esr, cbc, cmp, ddimer
CDC Split Type:

Write-up: nausea, gagging, fever, diarrhea, chills, chest pain


VAERS ID: 1640993 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Computerised tomogram head abnormal, Craniectomy, Critical illness, Endotracheal intubation, Intraventricular haemorrhage, Loss of consciousness, Malaise
SMQs:, Torsade de pointes/QT prolongation (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium, Vitamins
Current Illness: None
Preexisting Conditions: + smoker (daily), + EtOH use (daily)
Allergies: None
Diagnostic Lab Data: CT on 8/25 with findings of large right intraventricular hemorrhage
CDC Split Type:

Write-up: Intracranial hemorrhage 2 days after vaccine. Initially thought to be hypertensive hemorrhagic stroke but his wife informed us that he got the vaccine on Monday and had been feeling sick with chills. She found him unconscious in his bathtub. He was taken to the OR with neurosurgery for craniectomy, and remains intubated, critically ill at this time.


VAERS ID: 1641009 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-03
Onset:2021-08-25
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Pfizer on 3/3 and 3/24. Positive on 8/25 admitted on 8/25-current


VAERS ID: 1641012 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

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

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

Write-up: at 30 minutes post vaccine patient complained or redness to right inner arm; red streaks noted+ itching; small red spots noted; denies sob or itchy throat. patient continued to remained in conference room under observation. patient stated itchiness had decreased; streaks gone; approximately 4 red spots remained at additional 30 minutes post vaccination. MD came to see patient ; he recommended patient to take Benadryl and to watch rash ; if it increases or if sob, difficulty breathing occur patient to go to ER. patient verbalized understanding. left clinic ambulatory in no distress. patient remained in clinic for 1 hour.


VAERS ID: 1641013 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 2 LA / IM

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

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

Write-up: Received Dose #1 of Moderna on 3/30/2021


VAERS ID: 1641025 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-21
Onset:2021-08-25
   Days after vaccination:247
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / 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:
CDC Split Type:

Write-up: PATIENT RECEIVED PFIZER COVID VACCINE ON Dose 1 date: 12/21/2020 AND Dose 2 date: 01/11/2021. PATIENT TESTED POSITIVE TO COVID ON 8/23/21


VAERS ID: 1641027 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC183 / 1 LA / IM

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

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

Write-up: Patient wanted the Johnson and Johnson vaccine, but the administrator did not thoroughly review the consent form and administered Pfizer.


VAERS ID: 1641028 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Shortly after vaccination, patient began to feel light-headed and pale. Patient was given some water and ice pack and placed on observation for an additional 15 minutes. Patient''s symptoms shortly resolved and was discharged.


VAERS ID: 1641031 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

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

Write-up: arm developed instant temporary bruising on the bicep, forearm and pad of palm on her right arm! Not the arm she got the shot in. 5 minutes after he shot her arm turned blue and purple, like widespread bruising. No one had seen that happen before. and like 4 hours after the shot the discoloration completely went away. Never discomfort, swelling or fevers ar any other side effects, just crazy bruising all down her right arm. I yelled "she''s turning blue!" it was scary! But she was totally fine after.


VAERS ID: 1641042 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Memory impairment, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: reported that she had reaction to flu, no details given
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: Sulfa, Latex allergies
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Pt had been advised to stay in observation room for 30 mins following vaccination due to allergies. Pt called into Health Dept call center 8/26/21 and reported that after 5 minutes in observation room, she had been coughing, and proceeded to leave observation room and leave building without alerting anyone that she needed assistance; she reportedly went to parking lot and vomited and collapsed (per pt report). She drove home with her children (age 6, 6, and 11), reported not driving well, reported incomplete memory of events of evening after arriving home. Reported that she later went to ER where she was treated and later released.


VAERS ID: 1641045 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-24
Onset:2021-08-25
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 RA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1641055 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-04-10
Onset:2021-08-25
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

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

Write-up: Covid infection despite vaccination


VAERS ID: 1641069 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-12
Onset:2021-08-25
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaemia, COVID-19, Hepatic mass, Hepatocellular carcinoma, SARS-CoV-2 test positive
SMQs:, Liver related investigations, signs and symptoms (narrow), Haematopoietic erythropenia (broad), Liver malignant tumours (narrow), Non-haematological malignant tumours (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen PRN, albuterol PRN, Tums, ergocalciferol, ferrous sulfate, lasix, lactulose, Xalatan eye drops, metoprolol, mirtazapine, pantoprazole, potassium, spironolactone, tolterodine, ursodiol
Current Illness:
Preexisting Conditions: ESLD 2/2 PBC, chronic anemia, HTN, gastric AVM, esophageal varices, HHT, aortic stenosis
Allergies: celexa (nausea)
Diagnostic Lab Data: COVID-19 PCR positive 08/25/2021
CDC Split Type:

Write-up: patient had a positive COVID-19 test on 08/25/2021but did not have pulmonary symptoms related to this test. Incidental finding. She was admitted to the hospital with anemia and new large hepatic masses that was diagnosed as hepatocellular carcinoma. Patient ended up with a palliative/hospice approach due to her significant co-morbidities, but they were not related to pulmonary function or COVID-19. The test was positive when she was admitted to the hospital.


VAERS ID: 1641087 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-22
Onset:2021-08-25
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 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:
Current Illness: pre-DM, obesity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid infection despite vaccination


VAERS ID: 1641103 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: estradiol 1.5mg medroxyprogesterone 2.5mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: very swollen and sore glands in left armpit


VAERS ID: 1641104 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-11
Onset:2021-08-25
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: SARS-CoV-2 test
SMQs:, 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: N/A
Current Illness: N/A
Preexisting Conditions: NONE
Allergies: N/A
Diagnostic Lab Data: Antigen test
CDC Split Type:

Write-up: 08/25/2021


VAERS ID: 1641108 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram, Lymphadenopathy, Migraine, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG on 8/26/21
CDC Split Type:

Write-up: On 8/25/21 started having migraines. On 8/26/21 had swollen right sided clavicle lymph node, tingling down right arm, pressure on chest, continued migraines.


VAERS ID: 1641120 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry mouth, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: no illnesses, no chronic diseases, no vaccines in the past 4 weeks prior to this event.
Preexisting Conditions: none
Allergies: NO known allergies.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: The next morning patient woke up with dry mouth, pain all over her body with rash on her neck, chest and her back (the whole back). Patient denied any rash on extremities or legs. Patient advised to take Benadryl and call primary care provider. not outcome has been reported.


VAERS ID: 1641146 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-02-23
Onset:2021-08-25
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 2 UN / IM

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

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

Write-up: Covid invection despite vaccination


VAERS ID: 1641183 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Back pain, Joint swelling, Muscle spasms
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall Naproxen Progesterone only birth control Orphenadrine Fish oil Glucosamine Vitamin d Multivitamin
Current Illness:
Preexisting Conditions: Bulging and herniated disks on spine TBI Recent left ankle LCL repair and bone spur resection (12wks post op)
Allergies: Ibuprofen Versed Ondenseteron
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling and pain in ankle (the one I recently had surgery on). Increased pain and muscle spasms in back


VAERS ID: 1641194 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-22
Onset:2021-08-25
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EL0140 / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EJ1686 / 2 - / -

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

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

Write-up: Covid 19 + 08/26/2021 with onset 08/25/2021


VAERS ID: 1641196 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dehydration, Dry mouth, Headache, Heart rate increased, Injection site pain, Injection site swelling, Lip swelling, Oxygen saturation decreased, Pain, Pyrexia, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu, Tdap, Meningitis- Over 10 years ago - unsure
Other Medications: .5 Klonopin to stop any seizure; Xopenex inhaler; hydroxyzine; cataflam; ranitidine.
Current Illness: None.
Preexisting Conditions: Epilepsy; mitral valve prolapse; mass cell activation syndrome; POTS; low grade glioma brain tumor
Allergies: I''ve been living on an elemental formula because I''m allergic to all food. I''m allergic to almost everything. Latex; Aspirin; Ibuprofen; Tylenol; Formamidine; Cimetidine; Keppra; tetrytol; Hormonal birth control; Progesterone; Botox; Flu shot; Tdap; Tetanus
Diagnostic Lab Data: None. I only called my Doctor to see what medications I could take.
CDC Split Type: vsafe

Write-up: 08/25/2021 8 hours later That evening I started getting sore arm and mild swelling at injection site. Then the next day on 26th I developed a fever of 100.8 and I had body aches, especially in my hip joints, muscles, the injection arm, shoulder, neck, and chest pain. My pulse oxygen was back and forth between 94 and 96. I had some mild swelling of my lips and tongue and a mild headache and chills. I had slightly elevated heart rate all day yesterday that was around 100-115 at rest. I had Dry mouth and mild dehydration. As of today my fever has went down, but I still have dry mouth and I still have mild swelling and significant pain at injection site and some body and muscle aches and fatigue. Also Mild lip and mouth swelling. I also have mild blurry vision that is still ongoing.


VAERS ID: 1641248 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA LOT032B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure decreased, Cardiac telemetry, Electrocardiogram, Flushing, Hyperhidrosis, Pharyngeal swelling, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: Influenza - Paresthesia to Left foot
Other Medications: Multivitamins
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: EKG / Cardiac telemetry 8/25/21 No lab work
CDC Split Type:

Write-up: 40 minutes after vaccine administration - throat began to close up , BP dropped , face flushed, diaphoretic Emergency response called , oxygen via nasal cannula administered , Epi Pen 0.3 mg given to Right thigh Taken to Hospital in - Additional solumedrol and Famotidine given as throat began to swell again around 1505 and 1530. Discharged on Prednisone and Epi pen - advised to follow up with allergist/PCP


VAERS ID: 1641278 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-08-25
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Incidental finding during non-COVID related hospitalization


VAERS ID: 1641292 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Influenza like illness, Vaccination complication, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ocrelizumab for MS is the only one reported by patient
Current Illness: see 12
Preexisting Conditions: Has hx of chronic MS
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Received phone call from client. She stated ''Flu like symptoms with temp 100.3 and vaginal bleeding." Client stated there was no way the bleeding was normal, was not due for menses, but was heavier than menses. This began on 8/25/21. Client did see her physician on 8/26/21 who told her bleeding was from the vaccine. Stated bleeding has slowed some. Flu symptoms had resolved. Client has long term MS and takes ocrelizumab. Client will contact physician if bleeding continues, gets worse, or has other unusual symptoms. She wanted a VAERS submitted. She was told she could also submit a VAERS herself. She was enrolled in program for COVID-19 vaccination 1 & 2


VAERS ID: 1641397 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest pain, Cough, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: DM, HTN, anxiety.
Allergies: Bactrim, fioricet.
Diagnostic Lab Data: Covid test-positive, Cxr.
CDC Split Type:

Write-up: Pt came to ER with chest pain onset just prior to arrival. Pt also has cough.


VAERS ID: 1641404 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-19
Onset:2021-08-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)

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

Write-up: round rash around the injection site.


VAERS ID: 1641405 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-22
Onset:2021-08-25
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Tested PCR positive for COVID 8/25/21 after being fully vaccinated.


VAERS ID: 1641425 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Dysphemia, Eyelid ptosis, Headache, Hemiparesis, Magnetic resonance imaging head, Nausea, Vaccination complication
SMQs:, Acute pancreatitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: baclofen 20 mg oral tablet, 20 mg= 1 tab, Oral, TID Fioricet with Codeine 50 mg-300 mg-40 mg-30 mg oral capsule, 2 cap, Oral, every 4 hrs, PRN Fiorinal with Codeine oral capsule, 1 cap, Oral, every 4 hrs, PRN LORazepam 1 mg oral tablet, 1 m
Current Illness: unknown
Preexisting Conditions: Anxiety Brain mass Chronic mixed headache syndrome Headache Urinary tract infection VP shunt
Allergies: dihydroergotamine mesylate, reglan, Toradol and vancomycin
Diagnostic Lab Data: CT Brain/Head w/o Contrast 08/25/21 18:30:52 IMPRESSION: 1. There is no evidence of acute infarction. No hemorrhage is seen. 2. There is a stable left temporal ventriculostomy catheter seen with its tip in the region of the left middle cranial fossa, unchanged. MRI Brain w/o Contrast 08/25/21 17:36:43 IMPRESSION: 1. No evidence of acute intracranial pathology. 2. Left temporal shunt catheter, which is grossly stable in position. Slight prominence of the extraaxial spaces overlying the left anterior temporal lobe is unchanged. 3. Small focus of T2-weighted hyperintensity left posterior inferior cerebellum, new since the prior study and most concerning for a chronic infarct.
CDC Split Type:

Write-up: past medical history of anxiety, brain mass, chronic mixed headache syndrome, and a VP shunt placed in 2005 presenting with moderate headache that began 4 days ago, with a gradual onset, that is currently persistent. Patient also informed me that she received the Pfizer vaccine on 8/19/21 and she is since subsequently had drooping of the left eyelid, stuttering of her speech, but no slurred speech. Patient also endorses left-sided weakness worse in the lower extremity when compared to upper extremity. Patient has also been having persistent chronic headache, in which she takes baclofen, Fioricet, lorazepam, Norco and tramadol for pain. Patient has a history of a VP shunt and she denies any visual changes at this time. The patient has had similar headaches in the past, however this 1 is unable to be controlled with her prescription medication. Diagnosis/Assessment/Plan 1. Left-sided Bell''s palsy 2. Headache 3. Nausea 4. Slurred speech 5. Left-sided weakness 6. Vaccine reaction


VAERS ID: 1641430 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Paraesthesia, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient was lightheaded, vertigo and tingly 5 minutes after vaccine. States she felt worse 15 minutes later but declined epinephrine or medics. 25 minutes after vaccine took Zofran that she had in her purse and felt recovered enough to drive home by 35 minutes post vaccination


VAERS ID: 1641466 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-22
Onset:2021-08-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oral contraceptives
Current Illness: None
Preexisting Conditions: None
Allergies: Vicodin
Diagnostic Lab Data: Elevated troponin Normal EKG and echocardiogram
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1641489 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-26
Onset:2021-08-25
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion threatened, Exposure during pregnancy, Haemorrhage in pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

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

Write-up: O20.0 - Threatened miscarriage in early pregnancy VAGINAL BLEEDING - PREGNANT


VAERS ID: 1641510 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-21
Onset:2021-08-25
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Chest X-ray abnormal, Condition aggravated, Echocardiogram, Ejection fraction, Electrocardiogram abnormal, Lung opacity, Pulmonary congestion, Pulmonary oedema
SMQs:, Cardiac failure (narrow), Interstitial lung disease (narrow), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Chronic A-Fib, Cardiomegaly, CAD, HTN, post herpetic neuralgia, post cardiotomy syndrome, Tricuspid incompetence, Graves Disease, obesity, chronic pain
Allergies: Codeine
Diagnostic Lab Data: 8/26 Echocardiogram: EF 50-55, 8/25 Chest x ray showed central pulmonary venous congestion with bilateral interstitial opacities, suggestive of pulmonary edema. Initial EKG shows atrial fibrillation with RVR in the 130s
CDC Split Type:

Write-up: Brief hospitalization with suspect cxr findings more likely represent pulmonary edema, diuretics. Lasix IV,


VAERS ID: 1641522 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Injection site pain, SARS-CoV-2 test negative
SMQs:, Taste and smell disorders (narrow), Extravasation events (injections, infusions and implants) (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: Inflectra
Current Illness:
Preexisting Conditions: Crohn''s Disease
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Due to my being on an immunosuppressant drug, I elected to receive my third shot of the Moderna vaccine on August 23, 2021, approximately 4 months and 3 weeks after my second shot. Other than some slight pain that evening at the injection site I did not experience any other side effects until around 52 hours later. On the evening of August 25, 2021, I began to lose much, but not all, of my ability to taste. In trying different things, I only has the slightest hint of any taste (including for items such as peanuts and chocolate). The sensation was similar to when you might burn your tongue on a hot beverage. It lasted about 24 hours. Even though I had no other symptoms, as a precaution I did take the BinaxNOW home COVID test to be sure that the loss of taste was not due to an actual infection. I performed the test at home at 7:45 p.m. on August 26, 2021 and 15 minutes later it revealed a negative result. At the time of filing this report online I feel in good health with no side effects or symptoms and with my sense of taste fully restored. I''m reporting this because most information available indicates the loss of tatse only comes with a COVID infection, but mine came as a result of the third shot of Moderna.


VAERS ID: 1641547 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hallucination, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: Rapid heart rate, dizziness, weakness, hallucinations


VAERS ID: 1641548 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2020-12-22
Onset:2021-08-25
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 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? 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: Employee tested positive for COVID after being vaccinated with Pfizer vaccine.


VAERS ID: 1641592 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, Chills, Weak, Extreme Fatigue, Dizziness Resolved on own after 24 hours


VAERS ID: 1641645 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE7484 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None mentioned
Current Illness: No new diagnosis
Preexisting Conditions: Arthralgias, HTN, Muscle Aches, Pre diabetes, Hyperglyceridemia
Allergies: No known Allergies
Diagnostic Lab Data: No test performed.
CDC Split Type:

Write-up: Vaccine administered for the second dose was Pfizer and not the same vaccine administered for the initial vaccine of Moderna.


VAERS ID: 1641661 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE7484 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None mentioned
Current Illness: no new illnesses.
Preexisting Conditions: Allergic Rhinitis, benign hypertension, esophageal reflux, hyperlipidemia, abnormal glucose
Allergies: None noted
Diagnostic Lab Data: None
CDC Split Type:

Write-up: A Pfizer covid vaccine was administered as a second dose when her initial covid vaccine was a Moderna covid vaccine.


VAERS ID: 1641669 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardio-respiratory arrest, Dyspnoea, Intensive care, Myocarditis, Pain, Pneumonia, Renal failure, Respiratory arrest, Resuscitation, Staring
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patients wife states patient woke up gasping for air and couldn''t breathe so she called 911. His eyes became fixated so she initiated CPR and patient was transported to the hospital and is where he is in the ICU and has coded another 5 times per wife. She says he has double pneumonia which has led to myocarditis and kidney failure. They are still unsure if there has been any brain damage from lack of oxygen. Wife reports patient had no symptoms whatsoever before or after the vaccine until the onset Wednesday morning, besides a little soreness the day afterwards.


VAERS ID: 1641670 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Chills, Dizziness, Headache, Migraine, Palpitations, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: patient was taking and did take the morning of her vaccine an Herbal life supplement called herbal concentrate-it is a powder that is mixed with water.
Current Illness: reports that she did feel sick morning of appt with a sore throat. Also reports that her 2 children are sick now and she is awaiting COVID tests results for them. She said she is not aware of anyone that she was around that had COVID.
Preexisting Conditions: acid reflux hx migraines-did take Top Care Health MIgraine relief Wed afternoon as she vomited X 1 and felt like she was getting a migraine HA
Allergies: none
Diagnostic Lab Data: Possible EKG per patient report done at Heber 5 Minute Clinic that the patient thinks was normal
CDC Split Type:

Write-up: Tuesday after the vaccine she felt chills, fever and HA in the morning. Wednesday morning after the vaccine she felt heart palpitations, dizziness, chest pain, Vomited X 1 and headache/migraine. Has been having chest pain, dizziness and heart palpitations every since then


VAERS ID: 1641674 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Muscular weakness, Nausea, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Soreness and weakness of affected arm, fatigue, body aches, nausea, diarrhea


VAERS ID: 1641721 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone normal, Diplopia, Full blood count normal, Magnetic resonance imaging head normal, Metabolic function test, Red blood cell sedimentation rate increased
SMQs:, Ocular motility 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: MRI brain - negative CBC -normal BMP - normal ESR - 39 TSH 1.22
CDC Split Type:

Write-up: The patient developed vertical binocular diplopia two days after booster dose of Moderna vaccine.


VAERS ID: 1641743 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Headache, Injection site pain, Nausea, Rash, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Felt dizzy immediately. Nausea started up about 5 minutes later. Extreme pain in injection site. Felt better so drove home. About 3-4 hours later a red welt/rash appeared about the size of a dime. The it continued to grow to about 5? in diameter with extreme pain. Joints hurt, headache and exhaustion. Main complaint is the welt/rash on arm growing.


VAERS ID: 1641787 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Headache, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinus infection
Preexisting Conditions: Immunocomprmised. Single immune deficiency disorder.
Allergies: Antibiotics
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 103.6 temp for 48 hours after shot. Severe body aches, chills, headache, nausea, vomiting


VAERS ID: 1641845 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 - / IM

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

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

Write-up: 3 minutes after vaccination administration, pt went unconscious while sitting down in observation area for approx 30 seconds. Was assisted to supine position on floor by RN, RR was called get additional assistance. Resumed consciousness with inital confusion, mentation improved to baseline shortly after. VSS, monitored q2min for 15 minutes. Given granola bar and Gatorade once condition stabilized. Pt reported having not eaten prior to vaccination, had only consumed coffee that day. Pt observed for 30 minutes, VSS, escorted downstairs without assistance. No medications administered.


VAERS ID: 1641846 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Chest X-ray normal, Chest discomfort, Electrocardiogram ambulatory, Electrocardiogram normal, Heart rate increased, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine Prazosin Adderall
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 8/26/2021 Ekg Chest X-ray Bloodwork
CDC Split Type:

Write-up: After receiving the vaccine there was an evening that when I laid down for bed I started experiencing what felt like my heart was pounding. I went on to falling asleep and the next day I woke up fine. It wasn?t until Wednesday early morning that I noticed the tightness feeling in my chest, my heart feeling like it was racing, and the feeling I had to continue to take deep breaths. I continued through my day getting my girls ready for school and taking them to the bus stop. I continued feeling this way throughout the day. I begun monitoring my heart rate with my Apple Watch and my heart rate was anywhere between 100-147 bpm when I was standing or walking. When I finished my errands I returned home to rest on the couch hoping these feelings would pass. When I was laying down my heart rate was between 77-85 bpm. After getting my kids off of the school bus is when I decided to call my doctors office. I went into detail on what I was experiencing, what my heart rate was periodically, and that I have had the first dose of the Pfizer vaccine on the evening of 18th. The lady I spoke with was going to send the information off to my dr to see what she recommended. Not even 10 minutes later I received a call from the nurse practitioner from my doctor?s office asking me more questions about the type of vaccine and which one. The nurse then said my Doctor recommended that if my heart rate was 110 bpm or more that I need to go to the ER. I decided to take it easy for the rest of the evening and go to bed, I decided that if I continued to have these symptoms in the morning that then I would go to the immediate care. Thursday morning I woke up still with the symptoms. So I got my kids ready for school and went to the immediate care once they opened. When I went into immediate care they took me right back when they seen what my Watch was showing my heart rate was. I was then given an ekg which came back fine but with my heart rate being 124bpm while I was sitting with the dr she did not feel comfortable allowing me to leave unless someone picked me up and took me to the ER, and even offered to call an ambulance to take me over. I then called my husband who was at work to come get me and take me to the ER. Upon arrival at 10:37am they registered me in and took me back to take another ekg and to draw blood. I told them that when I?m laying down my heart rate is normal but once I stand and start walking it will jump 110 bpm and beyond. The highest it got yesterday was 158 bpm. They did a chest X-ray which came back normal and the ekg came back normal. After being in the ER for 11 hours I finally was taken back to see the On-call dr. He said that the ekg and X-ray looked great but because of the tightness in my chest and the high heart rate that he wanted to do more blood work to make sure I?m not clotting. After the bloodwork came back fine he discharged me but had an outpatient order for me to wear a holter monitor for 72 hours. After being at the ER for 12 1/2 hours I was finally discharged and on my way home. This morning I have called to set up an appointment for me to go back to Hospital to get the holter monitor which will be on September 7th. And today I continue with the same symptoms.


VAERS ID: 1641851 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Haemorrhage, Head injury, Nervousness
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypoglycaemia (broad)

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

Write-up: right after I injected pt with vaccine he jumped out of his chair onto the floor hitting his head on the table, pt was bleeding, stayed with the patient and mother for about 25 minutes made sure patient was feeling ok to leave


VAERS ID: 1642015 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad), Sexual dysfunction (broad)

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

Write-up: Bell palsy Thursday the whole right side of his face was numb


VAERS ID: 1642257 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-22
Onset:2021-08-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Headache, Hypersomnia, Lethargy, Myalgia, Rash, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasacort, Remicade, insulin, vitamin d, levothyroxine, Effexor, fluoxetine
Current Illness: None
Preexisting Conditions: Type 1 diabetes, mixed connective tissue disorder, hashimoros hypothyroid, Crohn?s disease
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on left arm (warm to touch, pink) on Wednesday. Took benedryl. Woke up Thursday to extreme headache, joint and muscle pain, extreme lethargy. Took ibuprofen, water. Slept almost 18 hours. Still feeling faint muscle/joint pain and headache on Friday.


VAERS ID: 1642263 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-08-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Bruxism, Sleep disorder, Tension
SMQs:, 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: codeine, opioids/morphine, methylprednisolone
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient said she is completely tense cannot relax/ cannot sleep. She says her teeth have been grinding.


VAERS ID: 1642275 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fatigue, Feeding disorder, Headache, Insomnia, Lacrimation increased, Muscle contracture, Muscle spasms, Myalgia, Nausea, Pain of skin, Pyrexia, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Lacrimal disorders (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Turmeric, glucosamine/chondroitin/MSM, ginger, vitamin D
Current Illness:
Preexisting Conditions: Spinal fusion, Inflammation, DDD, migraines, musculoskeletal problems, sciatica, tendonitis.
Allergies: Egg, sulfa, acetaminophen, codeine, epinephrine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense headache within 1 hour of vaccine, followed by dizziness and severe nausea. Tried to rest, but woke up shortly after with widespread muscle contractions, pain, and cramping. Headache was worse. Eyes were tearing uncontrollably. Fever measured 105.2 by forehead reading. Started to increase fluid intake and took aspirin for fever reduction at the advice of one of my doctors. Terrible fatigue and weakness followed. Unable to sleep since right after vaccination. Unable to tolerate solid food. Unable to sit upright in bed without fever spiking. Fever remaining between 102-103 with aspirin and cool compresses. Continued muscle cramps all over body. Headache resolving, but scalp tenderness remains. Changes in vision also.


VAERS ID: 1642477 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel Fe 24
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: redness and swelling to area of injection with local pruritis


VAERS ID: 1642856 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Aphasia, Feeling abnormal
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Flonase
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Brain fog. My wife asked me to change the battery in a smoke detector. Went downstairs to the kitchen to get a battery but forgot why I entered the room. Several times at work I have struggled to find the word I want to use. I have forgotten the name of coworkers I have worked with just a couple of months ago.


VAERS ID: 1642976 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: SARS-CoV-2 rapid antibody test; Result Unstructured Data: Negative. results showed zero antibodies.; Test Date: 20210820; Test Name: COVID-19 antibody test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210852120

Write-up: Confirmed Immunological Vaccine Failure; This spontaneous report received from a patient concerned a 62 year old white male of unknown ethnicity. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: Patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, expiry: 24-AUG-2021) dose was not reported, 1 total administered in left arm on 18-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date in AUG-2021, 2 Weeks ago, patient did a rapid antibody test at his local pharmacy and the results showed zero antibodies. Laboratory data included: SARS-CoV-2 rapid antibody test (NR: not provided) Negative. Patient heard that these tests that you get at a local pharmacy was not always accurate so he decided to get another test done at his doctor''s office. On 20-AUG-2021 he got blood drawn and today on 25-AUG-2021 the antibody test results came back as negative. Laboratory data included: Antibody test (NR: not provided) Negative and the patient experienced confirmed immunological vaccine failure. He does not know the name of the test but it''s similar to the Test. His doctor was aware of his test results and told him that these tests were not recommended. He wanted to know if he was still protected in this case. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was associated with a product quality complaint: 90000191002. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210852120-Covid-19 vaccine ad26.cov2.s-Confirmed immunological vaccine failure . This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1642983 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Hypotension, Nausea, Overdose, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug abuse and dependence (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (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: USJNJFOC20210853057

Write-up: RECEIVED FULL VIAL OF VACCINE (5 TIMES OF THE NORMAL DOSE); HYPOTENSION; CHILLS; VOMITING; FEVER; NAUSEA; This spontaneous report received from a physician 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, batch number: Unknown) dose was not reported, administered on 25-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 25-AUG-2021, the patient experienced received full vial of vaccine (5 times of the normal dose). On 25-AUG-2021, the patient experienced hypotension. On 25-AUG-2021, the patient experienced chills. On 25-AUG-2021, the patient experienced vomiting. On 25-AUG-2021, the patient experienced fever. On 25-AUG-2021, the patient experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from hypotension, fever, chills, nausea, and vomiting, and the outcome of received full vial of vaccine (5 times of the normal dose) was not reported. This report was non-serious.


VAERS ID: 1642984 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use; Atrial fibrillation (taking medications (not specified)); Blood pressure (taking medications (not specified)); Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies and did not have any drug abuse/illicit drug use. The patient had no past medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Body temperature; Result Unstructured Data: 104.1 F
CDC Split Type: USJNJFOC20210853377

Write-up: FEELING ACHY; FEVER; This spontaneous report received from a consumer concerned a 59 year old male. The patient''s weight was 350 pounds, and height was 80 inches. The patient''s concurrent conditions included: non smoker, alcohol use, blood pressure, and atrial fibrillation, and other pre-existing medical conditions included: The patient had no known allergies and did not have any drug abuse/illicit drug use. The patient had no past medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 24-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-AUG-2021, the patient experienced feeling achy. On 25-AUG-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 104.1 F. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feeling achy, and fever. This report was non-serious.


VAERS ID: 1642990 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210854764

Write-up: CHILLS; ARM HURTS; HEADACHE; FEVER; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 25-AUG-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 25-AUG-2021, the patient experienced chills. On 25-AUG-2021, the patient experienced arm hurts. On 25-AUG-2021, the patient experienced headache. On 25-AUG-2021, the patient experienced fever. The action taken with covid-19 vaccine was not applicable. The patient recovered from arm hurts, headache, and fever on 25-AUG-2021, and had not recovered from chills. This report was non-serious.


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