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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 393 out of 8,010

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VAERS ID: 1642996 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Florida  
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 - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Headache, Hyperhidrosis, Pain, Sinus congestion
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pollen allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210826; Test Name: Body temperature; Result Unstructured Data: 99.8
CDC Split Type: USJNJFOC20210854930

Write-up: SWEATS; CONGESTION; BLAZING HEADACHE; TEMPERATURE WAS 99.8; BODY ACHES; This spontaneous report received from a patient concerned a 42 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: pollen allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 211A21A 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 body aches. On 26-AUG-2021, the patient experienced sweats. On 26-AUG-2021, the patient experienced congestion. On 26-AUG-2021, the patient experienced blazing headache. On 26-AUG-2021, the patient experienced temperature was 99.8. Laboratory data included: Body temperature (NR: not provided) 99.8. The action taken with covid-19 vaccine was not applicable. The outcome of the sweats, body aches, blazing headache, congestion and temperature was 99.8 was not reported. This report was non-serious.


VAERS ID: 1643000 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Ohio  
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 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210855103

Write-up: VACCINE WAS GIVEN AFTER THE 2 HOURS LIMIT; INCORRECT PRODUCT STORAGE; This spontaneous report received from a pharmacist concerned a 41 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 (suspension for injection, route of admin not reported, batch number: 204A21A 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 vaccine was given after the 2 hours limit. On 25-AUG-2021, the patient experienced incorrect product storage. The action taken with covid-19 vaccine was not applicable. The outcome of the vaccine was given after the 2 hours limit and incorrect product storage was not reported. This report was non-serious. This case, from the same reporter is linked to 20210854907.


VAERS ID: 1643006 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
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 204B21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Cholesterol; Migraine; Non-smoker; Social alcohol drinker; Thyroid disorder
Preexisting Conditions: Medical History/Concurrent Conditions: Gastrooesophageal reflux disease; Insomnia; Comments: The patient had no known allergies, no drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210855331

Write-up: BODY ACHES; FELT EXTREMELY TIRED OR FATIGUE; FELT NAUSEOUS; HEADACHE; SORENESS IN ARM; This spontaneous report received from a patient concerned a 47 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: acid reflux, and insomnia, and concurrent conditions included: migraines, cholesterol, thyroid, occasional alcohol user, and non smoker, and other pre-existing medical conditions included: The patient had no known allergies, no drug abuse or illicit drug use. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204B21A, 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 soreness in arm. On 25-AUG-2021, the patient experienced felt nauseous. On 25-AUG-2021, the patient experienced headache. Treatment medications included: ibuprofen. On 26-AUG-2021, the patient experienced body aches. On 26-AUG-2021, the patient experienced felt extremely tired or fatigue. The action taken with covid-19 vaccine was not applicable. The patient recovered from soreness in arm, felt nauseous, and headache on AUG-2021, and had not recovered from body aches, and felt extremely tired or fatigue. This report was non-serious.


VAERS ID: 1643477 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Erythema, Flushing, Headache, Heart rate increased, Peripheral swelling, Pyrexia, Skin warm, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: 2nd Moderna vaccine: arm swelling and redness, malaise for 24 hours
Other Medications: Letrozole, Claritin, Flonase, viviscal, liquid collagen, melatonin, calcium
Current Illness: None
Preexisting Conditions: Breast cancer treatment completed 2019.
Allergies: Penicillin, erythromycin, morphine, codeine, naproxen, gadolinium (MRI contrast.)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Arm swelling followed by diffuse red warm areas. Headache. Rigors late evening the vaccine was given. Rapid heartbeat late evening the vaccine was given, Fever for 24 hours. Facial flushing and swelling 24 hrs after vaccine (still present after 48 hours.)


VAERS ID: 1644763 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 3 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Body temperature increased, Chills, Dizziness, Fatigue, Headache, Injection site pain, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Imatinib mesylate, atorvastatin, lisinopril, gabapentin, bupropion, clonazepam
Current Illness: None
Preexisting Conditions: GIST cancer 2019. Tumor successfully removed.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Soreness at injection site within 6 hours, shaking chills, headache, body ache, dizziness, fatigue, temperature increase to 102.6 within 20 hours. All symptoms gone after 36 hours.


VAERS ID: 1645408 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Injection site bruising, Peripheral swelling, Rash, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Bruising at Injection Site-Mild, Additional Details: Pt recieved vaccine at 12pm, was monitored for 15 min and no reaction developed. She noticed burning and swelling of her hands and feet, followed by a full body rash/hives between 11-1:30pm. She took 1 diphenhydramine 25mg followed by 3 separate doses after. She went to urgent care for eval and was given famotidine and prednisone. She was advised to not recieve any further doses of vaccine and proceed to ER if problems.


VAERS ID: 1651198 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abnormal uterine bleeding, Uterine spasm
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone, Zoloft, levothyroxine, Sprintec, Lansoprazole, Zyrtec
Current Illness: None
Preexisting Conditions: Anxiety, Depression, GERD, Hypothyroidism, Seasonal Allergies
Allergies: None
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Abnormal uterine bleeding and cramping


VAERS ID: 1651202 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysmenorrhoea, Menstruation irregular, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: Norethindrone
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderate period cramping and bleeding. This is completely irregular for me. These pains are much more intense than typical camping and period is was 100% unexpected. Had just finished last period the week before. Cycle is consist and and regular other than this.


VAERS ID: 1651256 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 RA / IM

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

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

Write-up: fever, aches, headache, fatigue


VAERS ID: 1651261 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-16
Onset:2021-08-25
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Extra dose administered
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: (This was third Pfizer injection. #1 was 02/08/21 and #2 was 03/01/21.) Levothyroxine 0.125mcg a day. Plaquinil/Hydroxychloroquine (for Rheumatoid Arthritis) 200mg twice a day. Prescribed Vitamins: D3 4000U, B12 1000U & K 100mcg daily. OTC
Current Illness: None
Preexisting Conditions: Rheumatoid Arthritis. BMI over 30.
Allergies: PCN
Diagnostic Lab Data: None yet except home pulse oximeter results crosschecked with a second pulse oximeter.
CDC Split Type:

Write-up: Don''t know when it actually started but.. used my wife''s pulse oximeter on Wednesday evening on date previously given (she has Hypoxemia and a number of other health problems and also may have had a more dramatic adverse event after her third shot). I was feeling very slightly short of breath. My oxygen saturation was 75. We monitored it the rest of the evening and I used some of her supplemental oxygen to get it back up. This is Saturday and I have been checking my oxygen saturation periodically since Wednesday. Though I don''t feel symptomatic, my O2 levels are routinely 90-93. They have been as low as 75-85. I had no problems with the first two shots except a sore arm and brief flu-like aches. I had that with shot #3 for only about maybe 5 hours. I got all three shots in the left arm. The first two were from my local Health Dept. I have a Primary Care Physician appointment in about 10 days and plan to mention it then unless I have to address it elsewhere first.


VAERS ID: 1651277 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: paracetamol


VAERS ID: 1651296 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-19
Onset:2021-08-25
   Days after vaccination:249
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Head discomfort, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Rec''d message to follow up for RN. Dept/Mgr: Rehab Resolution of Symptoms: n/a Covid-19 Vaccine Yes/No: Yes Date of last dose: 1/8/2021 Notes: Pt states on Wed 8/25, had mild sore throat. Developed fever 8/26 with congestion, runny nose, chills. Got tested yest am 8/26/2021, ? positive. Instructed to continue to quarantine, await further instructions. Instructed to call back hotline when released from quarantine for further RTW guidance. See email below. Informed that Pt tested positive for COVID-19, specimen collected 8/26/21. Vaccinated on 12/19/20 and 1/8/21 (Pfizer) Last day of work was 8/25/21. Patient reported that symptoms began on the evening of 8/25 after she got home from work. She first had a mild sore throat, followed by a 103F fever, chills, head congestion, runny nose. She denies body aches, loss of taste/smell, nausea, vomiting, diarrhea. She denies any recent large gatherings, or sick contacts. She runs and works out outdoors around her neighborhood. She and her husband recently vacationed from 8/21-8/23. They did not mingle with anyone else during their trip. They hiked but she said it wasn?t that crowded. At work, she has been primarily assigned to COVID patients and she always wears an N95 and eye protection for all patient encounters. However, her patients do not wear a mask during therapy because it makes them short of breath. She eats lunch with a small group of physical and speech therapists at the plexiglass picnic tables. Staff is pulling their names for me. She either walks to work or her husband drops her off. Pt lives with her husband who works remotely. He also had a mild sore throat starting on 8/25 but didn?t get tested. Pt gives consent to disclose her name for contact tracing purposes. Employee worked on 8/24 & 8/25 from 8am-4:30pm while infectious.


VAERS ID: 1651319 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Erythema, Myalgia, Peripheral swelling, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Breastfeeding and 2 weeks postpartum
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after injection the arm where I received it turned bright red and swollen along with muscle pain and weakness. 6 days later it has become itchy and it''s still sore and weak but improving.


VAERS ID: 1651325 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Feeling hot, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Right arm red, and spreading, soreness, hot to touch, hurts to touch or move


VAERS ID: 1651367 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Pain in extremity, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (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: Multivitamin, Effexor xr, Topamax, Aimovig, Nurtec ODT, vitamin d
Current Illness: No
Preexisting Conditions: Chronic migraine
Allergies: Levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm - large circular site reaction. Painful, raised, hot, itchy, red. Started day 2 following injection at injection site. Arm throbs and hurts to touch. Excessive thirst since night of vaccine. Have awoken every night at least 2 times to get a large glass of water (I never do this). I have also been craving water during waking hours since the day after vaccine.


VAERS ID: 1651375 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

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

Write-up: reports possible community exposure 8/22/21. Onset of symptoms (pounding headache) 8/25. Called in sick for work 8/26. Covid test collected 8/26. 8/27 resulted positive. confirms remains in quarantine and able to isolate from household/roommate(s) per CDC guidelines.


VAERS ID: 1651389 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-22
Onset:2021-08-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Echocardiogram, Electrocardiogram abnormal, Myocardial infarction, Pain, Pericarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), 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? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vyvanse 70mg aripiprazole 10mg Zyrtec 10mg He had drunk a Monster energy drink the previous day at 5pm.
Current Illness: n/a
Preexisting Conditions: ADHD, Asperger''s, OCD
Allergies: n/a
Diagnostic Lab Data: EKG and heart ultrasounds. Original EKG had abnormal levels at the ER and he was instantly admitted. Subsequent ekg''s were fine. All heart ultrasounds were fine. His troponin levels were at 7000 the first day, then 2000 the next day, then up to 3800 on the next day, and down to 1000 today (8/28/21).
CDC Split Type:

Write-up: Pericarditis associated with myocardial infarction. He felt a lot of pressure on his chest as if someone was standing on his chest. He had a lot of pain.


VAERS ID: 1651472 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWE182 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Fatigue, Productive cough, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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

Write-up: fatigue, extreme hives on site of elbow joints and arms; then hives all over legs, knees, ankles and up the backside; coughing, phlem with no prior history of illness or congestion; fever


VAERS ID: 1651543 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-25
Onset:2021-08-25
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient exposed to husband exposed to coworker COVID (+), husband having symptoms 8/20/2021, whole family took test 08/21/2021 all COVID (+), patient having symptoms 08/25/2021, retested COVID (+) 08/26/2021. .: 08/25/2021, sl cough, sensation of something stuck in throat, still with sensation in throat currently. Patient denies recent travel, still with funny throat sensation.


VAERS ID: 1652761 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-14
Onset:2021-08-25
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: Tree nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid-19


VAERS ID: 1653571 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Balance disorder, Cough, Diarrhoea, Dizziness, Dysarthria, Hallucination, Headache, Impaired work ability, Insomnia, Lymphadenopathy, Malaise, Nasal congestion, Nausea, Pain, Pyrexia, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 07/22/2021, 1st Pfizer covid vaccine, age 51
Other Medications: Valtrex 500 mg daily, lisinopril-HCTZ 20-12.5 mg daily, protonix 40 mg daily, zoloft 150 mg daily, vitamin B12 injection monthly, aspirin 81 mg daily, trazodone 50 mg nightly pen, bentyl 20 mg pen, zofran 8 mg ODT prn, fish oil, turmeric, g
Current Illness: Hypertension, high cholesterol, osteoporosis, vitamin B12 deficiency, hypoglycemia, IBS, insomnia, GERD, immune deficiency
Preexisting Conditions: Hypertension, high cholesterol, GERD, osteoporosis, vitamin B12 deficiency, IBS
Allergies: Dilaudid, Reglan, compazine, droperidol, phenergan, ancef., TB skin test
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, dizziness, cough, stuffy nose, low grade fever, nausea, vomiting, diarrhea, body aches, joint pain, weakness, swollen lymph nodes. After the 1st covid vaccine, I felt like I had covid again for 9 days. I had covid last year that affected me for 3 months. I was unable to work with long lasting hey to symptoms, headache, nausea & vomiting, slurred speech, dizziness, hallucinations, shaking, weakness, insomnia, loss of balance. I had the 2nd covid injection 4 days ago and again, I''m very sick. Why?


VAERS ID: 1653575 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-13
Onset:2021-08-25
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site reaction, Rash papular, Skin warm
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: Wellbuttrin
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Raised rash around injection site. Rash seems to have fever in it. It feels warm to the touch.


VAERS ID: 1653751 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 3 LA / IM

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

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

Write-up: Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient noticed a half-dollar sized lump/red area that is hot to touch and gradually grew to palm-sized lump/red area below injection site, told patient to monitor and if it gets any worse or other symptoms persisted to follow up with PCP or ER depending on symptoms.


VAERS ID: 1653753 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A2IA / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 10 mg, albuterol PRN, omega 3
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: Morphine
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Swelling, redness, itching, large bruise, pain at the injection site. Redness is shown on arm about 4 inches in length, 3 inches in width that has gotten progressively worse the past few days . I will be doing a virtual appointment with my primary care physician today to discuss further.


VAERS ID: 1653755 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-25
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Fatigue, Headache, Myalgia, Nodule, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever, muscle pain and fatigue starting a few hours after the vaccine.
Other Medications: None
Current Illness:
Preexisting Conditions: Interstitial cystitis
Allergies: Phosphate
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 24 hours a very strong body ache began, accompanied by fever for approximately 8 hours, very tired. Just after 15 days the fatigued returned, fever, chest pain (feeling of pressure or knot) muscle pain, headache.


VAERS ID: 1653772 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Erythema, Hypersensitivity, Swelling, Swelling face, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Approximately 5 days post-initial injection, severe histamine, allergic reaction with skin redness and swelling covering entire body. From head to feet, circumferential redness, tachycardia (HR $g130), and Shortness of breath. Treated with 50mg benadryl, 300mg glucocorticoid, and 10mg of Famotidine. Medicine administered within 30 min of symptom onset Facial swelling lasted approximately 2-2.5hrs post medication administration. Whole body redness lasted 5 hours from initial reaction.


VAERS ID: 1653789 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Burning sensation, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Lymphadenopathy, Pain in extremity, Skin warm
SMQs:, Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse, Lexapro, Methotrexate, Zyrtec, Allegra, Aygestin, Vitamin C, Vitamin D3, Inulin, Apple Cider Vinegar, Ashwaganda, Cod oil, Tumeric, Magnesium
Current Illness: eczema
Preexisting Conditions: eczema
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Axillary pain, swelling, warm. Arm pain, shoulder pain, unable to lift arm without burning pain. Injection site diameter of red, warm, swelling, pain, itching, getting bigger.


VAERS ID: 1653794 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache, Hunger, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Copaxone 40ml Injection 3 times weekly; Baclofen 10 mg 3 times day; Ramipril 2.5 mg 1 time daily; Simvastatin 40 mg 1 time daily; Esomeprazole 20 mg 1 time daily; Vitamin D supplement 3,000 IU daily; One-a-Day Women?s Multi Vitamin; and
Current Illness: No
Preexisting Conditions: Diagnosed in 2015 with Multiple Sclerosis; High Blood pressure 2015; GERD 2000
Allergies: Sulpha drug allergy and skin allergy to adhesives
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Woke up with chills, progressed over next 2 days to fever of 101.8; severe headache and vomiting, progressed to diarrhea with abdominal cramping; received needle on Tuesday August 24 2021 and still feeling some side effects of diarrhea with abdominal upset today Sunday August 29. Fever diminished, headache diminished, but feeling fatigued and somewhat foggy brain, hungry eating light meals, drinking plenty of Vitamin and/or SmartWater.


VAERS ID: 1653936 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest discomfort, Dyspnoea, Headache, Hyperhidrosis, Influenza like illness, Injection site pruritus, Mobility decreased, Oropharyngeal pain, Pain, Pyrexia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (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: 81 mg aspirin
Current Illness: None
Preexisting Conditions: None
Allergies: Flagyl
Diagnostic Lab Data: Going to primary tomorrow
CDC Split Type:

Write-up: 17 hours after 2nd dose I began feeling all the flulike symptoms. Fever as high as 102 sweats aches pain blurry vision. Could not hardly move. Injection site itched. Sore throat headache breathing difficult. It is 5 days after the shot and I am still running a low grade fever chest heavy blurry vision and abdominal pain


VAERS ID: 1653939 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Headache, Heart rate increased, Heart rate irregular, Meningitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Meningitis, fever 101, headache, chest pain, elevated heart rate (resting is 61, heart rate while laying flat was 92. Sleeping heart rate is 52, woken up with heart rate exceeding 104), fluctuating heart rate while inactive.


VAERS ID: 1653943 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-01
Onset:2021-08-25
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, Anticoagulant therapy, C-reactive protein increased, Catheterisation cardiac abnormal, Chest discomfort, Electrocardiogram abnormal, Influenza like illness, Influenza virus test negative, Malaise, SARS-CoV-2 test, Troponin increased, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient reported none
Current Illness: Patient reported no past medical history.
Preexisting Conditions: none
Allergies: Patient reported none
Diagnostic Lab Data:
CDC Split Type:

Write-up: 08/28/21 Height 6ft 3 in weight 107kg 56yo M transferred to Hospital for Cath Lab procedure from another Hospital -Posterior STEMI alert. Patient stated to have no medical history or on any medications. He reported receiving both Pfizer vaccines (second dose mid to end of July). Patient started feeling ill on 08/25/21 chest pressure, flu like symptoms. Rapid flu /covid test negative. VSS. At arrival to ED patient had elevated troponin at 29.88, WBC 17.43 CRP 207.4 EKG +STEMI, afebrile on ra o2 98% and BP and HR normal limits . PCR covid pending. Patient''s symptoms prior to Cath Lab was chest pressure with inspiration 5/10. He received Heparin 4000Units, Morphine 2 mg and ASA 324mg. Cath Lab results showed 60%mid vessel lesion, 98% lesion in mid vessel cannot r/o bridging collaterals, Mid LCxs most likely the culprit.


VAERS ID: 1653948 (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: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / JET

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Paraesthesia, Rash, Skin indentation, Skin wrinkling
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got my JAB around 2:30 on Wednesday, August 25. Yes, I was a little anxious not in a good way, but I did it. First sign of trouble may have been when I got up from the chair after the JAB, I had a splint second of dizziness, but brushed it off as normal, because this does happen to me when I get up too fast due to low blood pressure. *(1) I was brought to waiting area for a 15 minute watch period. I set my phone for 15 minutes and felt ok during this time, just anxious to leave, concerned about what I have done. Was it smart or not. As I walked out of the building to my car, I started feeling tingling in lower face. As I drove out of town it got worse but not overly concerning yet. I had numbness/tingling on both sides of lower face. During this time he called me, and I told him I was considering staying in town, but decided to drive home, and if it continued or got worse, I would go the ER. The sensation lasted for about 30-40 minutes I kept checking my smile for any changes during this time. It felt like after a dentist numbs your mouth for dental work and it''s wearing off, just before you can eat again without biting one''s lip or tongue. For the rest of Wednesday night, I can''t say if there was a strange feeling or not, but I was a bit anxious. Thursday morning, I woke up about 5:00am and knew something just didn''t feel right with lower face, especially right side. When I finally checked in the mirror I noticed two reddish spots on the right side of my face near the mouth, one of these spots had a slight indentation, plus from nose to the mouth region I noticed wrinkles that were more defined. I took pictures to see the changes. Finally, at 7:20am I decided to go to Urgent Care before work instead of waiting to see if feeling subsided and face changes would reverse themselves. But I thought I remembered from my previous Bell''s Palsy episode (at the time I couldn''t remember date, but now I know it was 2002 diagnosed by Dr.) that treatment needed to start soon after episode so that damage would not be permitted (that episode was more severe affecting my smile.) When I got to the hospital, I went to Urgent Care but was sent to ER. I was very anxious at time and being sent to ER made it worse (see my experience with ER to why my anxiety was high), it was obvious because I was not thinking clearly (but your staff wouldn''t have known that), I kept my foot moving, and kept moving my hand cause beeps with oxygen, pulse monitor. I did mention to the nurse I was having anxiety issues over this. I am grateful I took pictures, because it keeps reminding that it wasn''t just in my head, because I had the feeling that is what the staff thought, especially seeing it was hard see the difference. Later when I was able to review what the ER wrote I began angry, that''s when I decide to take report on my own. They wrote information of events wrong, ER doctor stated he told me it wasn''t due to vaccination. He never said that to me. His notes stated because symptoms began 2 hrs after vaccination (which was wrong time frame). Reason I''m upset, because CDC site even states side effects can take up to 48 hours to happen.


VAERS ID: 1653985 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-19
Onset:2021-08-25
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Blood electrolytes, COVID-19, COVID-19 pneumonia, Cardiac telemetry abnormal, Computerised tomogram thorax abnormal, Condition aggravated, Coronary artery disease, Deep vein thrombosis, Hyperlipidaemia, Hypertension, Hypokalaemia, Insomnia, Liver function test increased, Myocardial ischaemia, Pulmonary mass, SARS-CoV-2 test positive, Treatment noncompliance, Troponin increased, Urinary retention, Vaccine breakthrough infection, Vitamin D deficiency, Walking distance test
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Hypertension (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Lipodystrophy (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 2.5 MG Oral Tablet TAKE 1 TABLET DAILY 7/27/21 aspirin 81 MG Oral Tablet Take 81 mg by mouth daily. Information, Historical atorvastatin (LIPITOR) 80 MG Oral Tablet TAKE 1 TABLET NIGHTLY AT BEDTIME 1/19/21
Current Illness:
Preexisting Conditions: ? CAD (coronary artery disease) ? Hypertension
Allergies: NKDA
Diagnostic Lab Data: SARS-COV-2, NAA, Detected 08/25/21.
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. He received Pfizer vaccine (2nd dose in series) on 03/19/21. Patient was hospitalized from 08/25/21 - 08/28/21. Below is copied from discharge summary: Acute respiratory failure with hypoxia 2/2 COVID 19 PNA: - uptititrate O2 as needed to keep O2 sat$g92 - continue Decadron IV - continue IV Remdesevir, monitor LFT''s - symptom management with prn meds - Isolation Hyperlipidemia - lipitor 80 mg daily Hypokalemia, resolved -Monitor Elevated LFTs monitor AKI/Urine retention, improved - Flomax 0.4 mg daily Vit D deficiency: -Vit D 1.25 mg weekly Elevated troponin, likely from demand ischemia -Telemetry Left lung mass: - 1.5 cm - F/U OPD with CT chest as recommended by Radiology HTN, fairly well controlled - Stable - Resume losartan, hold HCTZ - continue amlodipine Insomnia: Continue trazodone CAD s/p DES: - Stable ASA+statin Morbid Obesity, BMI of$g40: - would benefit from lifestyle modifications regarding low fat diet, weight loss and daily excercise - F/U OPD with PCP Vitals and labs personally reviewed. PT/OT: DVT PPx. Lovenox His electrolytes, pain and vitals were monitored and optimized during the course of hospitalization. Patient''s symptoms improved and he remained hemodynamically stable. Patient wanted to go home and self isolate at home. 6 MIN WALK TEST WAS DONE, PT SENT HOME ON HOME O2 POOR ADHERENCE AND POOR INSIGHT, HIGH RISK OF RE-ADMISISON Discharge Diagnoses: Acute respiratory failure with hypoxia 2/2 COVID 19 PNA


VAERS ID: 1654000 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, metformin, spironolactone, Vitmains B-C-D, Coq-10, zinc
Current Illness: none
Preexisting Conditions: Hashimotos'' and PCOS
Allergies: minocycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbness in left and face progressed to numbness in right arm and face by day 3 after vaccine.


VAERS ID: 1654023 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Fatigue, Headache
SMQs:, Anaphylactic reaction (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: Td, age 16, red swollen, sore arm for seven days at injection site
Other Medications: Doxycycline, cefepime, Vitamin D3, Magnesium
Current Illness: Bacterial upper respiratory infection
Preexisting Conditions: Asthma, POTS
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache Extreme ongoing fatigue starting the day after vaccination and ongoing Chest discomfort, ongoing


VAERS ID: 1654048 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Dyspnoea, Fatigue, Gait disturbance, Hyperhidrosis, Muscular weakness, Myalgia, Nausea, Presyncope
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Had Covid positive in January 2021
Allergies: N/A
Diagnostic Lab Data: 8/26/21: Called nurse monitoring symptoms. Now 8/29/21 most symptoms resolved. Now feeling only moderate muscle joint pain and fatigue
CDC Split Type:

Write-up: 08/25/21: (1) day post vaccine-Event- had severe muscle pain, weakness from right arm to right foot, made walking difficult lasted a several hours then went away. 8/26/21: (2) days post vaccine- Event- nausea, with pre syncope feeling faint, profuse sweating, difficulty breathing and had to keep sitting down so I wouldn''t pass out-lasted 1.5 hour then went away.


VAERS ID: 1654122 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-06-14
Onset:2021-08-25
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Full blood count, Heavy menstrual bleeding, Menstrual disorder, Thrombosis, Ultrasound scan vagina
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Pre natal vitamins
Current Illness: C section
Preexisting Conditions: PCOS
Allergies: Penicillin letrozole
Diagnostic Lab Data: Vaginal ultrasound, CBC. Possibly other blood tests. I know one was done in preparation for a blood transfusion if needed
CDC Split Type:

Write-up: Heavy menstrual bleeding with heavy clotting a week and a half after period was complete. Heavy bleeding started on 8/27/2021 which resulted in visit to ER. Clots were the size of a golf ball which had never been experienced prior to vaccine. Third period since c section on May 12th., 2021


VAERS ID: 1654136 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-01
Onset:2021-08-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anal incontinence, Chills, Diarrhoea, Fatigue, Headache, Hyperhidrosis, Hypophagia, Impaired work ability, Nausea, Pain, Retching, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: N/A
Current Illness: Low blood pressure Dysmenorrhea Irregular period UTI
Preexisting Conditions: Syncope Low blood pressure Dysmenorrhea Irregular periods UTIs
Allergies: Unknown cause of anaphylaxis 2018, hasn?t occurred since
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Reporting as of 8/29, second Pfizer dose in 8/25 Chills Sweats Headache Extreme nausea, dry heaves, and vomiting Can?t keep any food or liquids down Diarrhea & fecal incontinence Fatigue Body ache Received the same series of side effects for both doses. Can?t function at work Delayed on right forearm and under chin reported 8/28


VAERS ID: 1654187 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral artery occlusion, Computerised tomogram head, Condition aggravated, Embolic stroke, Hemiparesis, Magnetic resonance imaging head, Seizure like phenomena, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
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: Albuterol Inhaler PRN Zyloprim Daily Eliquis 2xday Lipitor Daily Advair diskus Lasix 2xday Labetalol 2xday Lantis 2xday Cozaar Daily
Current Illness:
Preexisting Conditions: Hx of previous stroke COPD, A-Fib, HTN, CHF, DM
Allergies: Iodine
Diagnostic Lab Data: CT/MRI of brain
CDC Split Type:

Write-up: Pt. received Pfizer Covid shot #1 on 8/2/21 by unknown provider. Presented to Medical hosp 8/22/21 for stroke like sx - stroke work up completed in patient - found to have R MCA occlusion likely cardioembolic. Pt. discharged 8/24/21 - Pfizer Covid shot #2 given at Med hospital on day of discharge. Pt. returned to Med hospital on 8/25/21 with new onset unresponsiveness/seizure like episode & worsening L sided weakness & deficits. Admitted in patient for work up, & found to have worsened Rt MCA diffusion restriction extending up to the posterior arterial watershed zone, likely cardio embolic.


VAERS ID: 1654985 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Blood glucose decreased, Body temperature, Diarrhoea, Fatigue, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Anemia; Contrast media allergy; Diabetic; Pancreatitis
Preexisting Conditions: Comments: Patient had no daily medications.
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Blood glucose; Result Unstructured Data: dropped; Test Date: 20210826; Test Name: Body temperature; Result Unstructured Data: 99.7 F
CDC Split Type: USJNJFOC20210855035

Write-up: WATERY DIARRHEA; VOMITING; MUSCLE ACHES ALL OVER; FEVER 99.7 DEGREES FAHRENHEIT; NAUSEA; TIREDNESS; FELT LIKE BLOOD SUGAR DROPPED; This spontaneous report received from a patient concerned a 52 year old female. The patient''s weight was 110 pounds, and height was 70 inches. The patient''s concurrent conditions included: diet controlled diabetic, pancreatitis issues, anemia, and allergic to contrast ct dye, and other pre-existing medical conditions included: Patient had no daily medications. The patient experienced drug allergy when treated with morphine, and ondansetron. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204A21A and 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 felt like blood sugar dropped. On 25-AUG-2021, the patient experienced tiredness. Laboratory data included: Blood glucose (NR: not provided) dropped. On 26-AUG-2021, the patient experienced watery diarrhea. On 26-AUG-2021, the patient experienced vomiting. On 26-AUG-2021, the patient experienced muscle aches all over. On 26-AUG-2021, the patient experienced fever 99.7 degrees fahrenheit. On 26-AUG-2021, the patient experienced nausea. Laboratory data included: Body temperature (NR: not provided) 99.7 F. Treatment medications (dates unspecified) included: tizanidine hydrochloride, and paracetamol. The action taken with covid-19 vaccine was not applicable. The patient recovered from felt like blood sugar dropped on 25-AUG-2021, and fever 99.7 degrees fahrenheit, was recovering from watery diarrhea, had not recovered from tiredness, muscle aches all over, and nausea, and the outcome of vomiting was not reported. This report was non-serious.


VAERS ID: 1655370 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0939901 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Incorrect route of product administration, Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Limb injury, Paraesthesia, Underdose
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Drug abuse and dependence (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Medication errors (narrow)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Medium, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-, Additional Details: where patient points to inject being made and where redness and swelling appears is approximately 2" from the top of shoulder, patient is a nurse at local outpatient facililty and was concerned about the injection as soon as it was given, said it sseems rather high to her. patient also noted large amount of fluid leaked back out down arm.


VAERS ID: 1655377 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-15
Onset:2021-08-25
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 2 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Swine flu vaccine
Other Medications: Metropalol 25.mg
Current Illness: No
Preexisting Conditions: Hypertension
Allergies: Pennacillian
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme vertigo with neausa. Currently day 5 still very dizzy when waking up and standing or laying down. No fever No issues prior to this.


VAERS ID: 1655568 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Back pain, Chills, Diarrhoea, Fatigue, Headache, Hyperhidrosis, Myalgia, Nausea, Pain, Pyrexia, Sleep disorder, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (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: Birth Control Pills, Zyrtec, Monthly Allergy Shots (Seasonal).
Current Illness:
Preexisting Conditions: Obese, Depression, Anxiety
Allergies: n/a
Diagnostic Lab Data: Temperature Monitoring at home routinely
CDC Split Type:

Write-up: Fever, Chills, Sweats, Body Ache, Lower Back pain, headache, Vomiting, Exhaustion, Diarrhea, Sore Muscles, trouble sleeping, nausea for 4 Days


VAERS ID: 1655615 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-16
Onset:2021-08-25
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccine breakthrough infection
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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine breakthrought. Inpatient admit 8/25-8/29/21


VAERS ID: 1655773 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-20
Onset:2021-08-25
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Influenza like illness, Pain, 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: Body aches, COVID + 8/21. FLU LIKE SYMPTOMS


VAERS ID: 1655787 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Bedridden, Gait inability, Muscle spasms
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre 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
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: sharp muscle spasms in lower back, unable to walk; bed ridden.


VAERS ID: 1655824 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-31
Onset:2021-08-25
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, 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: COVID Positive 8/27/21


VAERS ID: 1655855 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: Constant headache


VAERS ID: 1655899 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-27
Onset:2021-08-25
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: COPD, lupus, OSA, CKD 2, Diabetes mellitus, hypothroidism.
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: SOB, weakness, hospitalization.


VAERS ID: 1655930 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: The guardian filling out the vaccine consent form with a date of birth of not exact to meet the criteria for the Pfizer Covid19 immunization. The form was signed by the mother. I tried to reach the mom of the patient on 08/27/2021 to confirm the date of birth. I left a message to call me back at the pharmacy. I was able to reach the mom on 08/30/2021. Mom informed me that the wrong date of birth was on the form and that she must have mistakenly put it in for a sibling of the patient. The actual date of birth is exact. There were no reported adverse effects of the vaccine. I also informed the mom that under current guidelines that I was not able to provide the second shot to the patient since he did not meet the age requirements.


VAERS ID: 1655953 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Conjunctival oedema, Conjunctivochalasis, Meibomian gland dysfunction, Slit-lamp tests abnormal
SMQs:, Angioedema (narrow), Glaucoma (narrow), Corneal disorders (broad), Conjunctival disorders (narrow), Periorbital and eyelid disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxazosin, tranzodone, montelukast, losartin
Current Illness: None
Preexisting Conditions: Sleep apnea
Allergies: None
Diagnostic Lab Data: Slit lamp exam
CDC Split Type:

Write-up: Meibomian gland dysfunction everted lid, conjunctivochalasis indeterminate chemosis 2+ both eyes


VAERS ID: 1655964 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Headache, Hypoaesthesia, Myalgia, Nausea, Oropharyngeal pain, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: general weakness, headache, numbness in the left arm, muscles pain, sore throat, runny nose, nausea, dizziness, forgiveness.


VAERS ID: 1656050 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-20
Onset:2021-08-25
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Citalopram; Crestor; Glimepiride; Hydroxyzine; Metformin; Omeprazole; Propranolol, Triamterene-HCTZ, low dose aspirin
Current Illness: none
Preexisting Conditions: polyarthritis; hyperlipidemia, hypothyroidism; depression, GERD, reactive airway disease, diabetes; general anxiety
Allergies: prednisone, Lipitor, Doxycycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Congestion headaches, sore throat starting on 8/25/2021


VAERS ID: 1656085 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-29
Onset:2021-08-25
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Mental status changes, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lipitor, celebrex, flonase, neurontin, hydrodiuril, claritin, omeprazole, ditropan, zanaflex, cerapamil
Current Illness:
Preexisting Conditions: Essential HTN, SVT, TIA, GERD, PUD, osteoarthritis, OSA, OAB, APL, fibromyalgia, obesity
Allergies:
Diagnostic Lab Data: positive covid on admisson 8/25/2021
CDC Split Type:

Write-up: Altered mental status


VAERS ID: 1656106 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-08-25
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, norvasc, vitamin D, flexeril, banophen, pepcid, neurontin, multivitamin, renegel, zanaflex,
Current Illness:
Preexisting Conditions: essential hypertension, CHF, renovascular hypertension, hypotension, Type 2 diabetes, asthma, ESRD,
Allergies:
Diagnostic Lab Data: Covid positive on admission 8/25/2021
CDC Split Type:

Write-up: Small bowel obstruction


VAERS ID: 1656134 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Condition aggravated, Electrocardiogram, Fibrin D dimer, Hypertension, SARS-CoV-2 test negative, Troponin I increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (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: amiodarone (Pacerone) 200 MG tablet aspirin, antiplatelet dose, 81 MG chewable tablet atorvastatin (Lipitor) 80 MG tablet clopidogrel (Plavix) 75 MG tablet ferrous sulfate 325 mg 325 (65 FE) MG tablet furosemide (Lasix) 40 MG tablet metopro
Current Illness: Acute on chronic combined systolic and diastolic congestive heart failure Acute systolic heart failure Atherosclerosis of coronary artery Ischemic dilated cardiomyopathy HTN (hypertension)
Preexisting Conditions: Vaginal vault prolapse after hysterectomy
Allergies: NKMA
Diagnostic Lab Data: Troponin I 0.071, EKG, D Dimer501, SARS COV2 negative
CDC Split Type:

Write-up: Chest pain, hypertension, Elevated Troponin


VAERS ID: 1656145 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-24
Onset:2021-08-25
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Blood creatinine increased, C-reactive protein increased, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Exposure to SARS-CoV-2, Fibrin D dimer, Headache, Hypoxia, Intensive care, Leukocytosis, Lung opacity, Malaise, Pyrexia, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), 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: unknown
Current Illness: unknown
Preexisting Conditions: obesity, CAD s/p 5 stents (last stented in 2016), HTN, HLD, depression, neuropathy 2/2 cervical injury in 1990''s, b/l glaucoma, h/o cornea transplant, BPH
Allergies: NKA
Diagnostic Lab Data: Diagnostic Results Diagnostic Results (08/25/2021 23:23 CDT XR Chest Portable) INDICATION: cough, fever, hypoxia; COVID 19 infection VIEWS: 1 view of the chest COMPARISON: May 26, 2021 chest radiograph and multiple priors FINDINGS: ACDF hardware. Partially visualized leads terminate overlying the mid thoracic spine. Normal cardiomediastinal silhouette. Diffuse bilateral airspace opacities left greater than right. No pleural effusions. No pneumothorax. No acute osseous abnormalities. IMPRESSION: Diffuse bilateral airspace opacities left greater than right consistent with COVID-19 pneumonia.
CDC Split Type:

Write-up: Chief Complaint short of breath, fever History of Present Illness 65yo male with obesity, CAD s/p 5 stents (last stented in 2016), HTN, HLD, depression, neuropathy 2/2 cervical injury in 1990''s, b/l glaucoma, h/o cornea transplant, BPH, presenting to the ER with 3-days history of headache, persistent cough, and malaise. Patient oxygenation worsened on 8/27 and was thus transferred to MICU on 60% FiO2 at 50 L/min. Patient reported that his grandson was visiting for a week 3 weeks ago. His grandson was sick at that time and found out he had Covid later. Patient then began to have persistent cough 3 days ago and had trouble breathing. He had Covid vaccine back in April-May 2021. Initial labs were notable for leukocytosis 19k, Cr 1.43 (Cr 1.3 baseline), elevated D-dimer 0.79, CRP 19.53. CXR showed bilateral airspace opacities. CTPE was negative for PE but showed multifocal opacities. Patient was started on remdesivir, dexamethasone, and barictinib.


VAERS ID: 1656161 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-12
Onset:2021-08-25
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN1802070 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Central venous catheterisation, Computerised tomogram, Electrocardiogram abnormal, Myocarditis, Pericarditis, SARS-CoV-2 test, Scan with contrast
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG came back abnormal COVID TEST CVC CT with and w/o contrast
CDC Split Type:

Write-up: Patient went to the ER on 8/25/2021. Patient was diagnosed Midiocarditis And pericarditis. Went to the hospital to follow up with primary DR on 8/27/21. DR put him on a 3 moth predication.


VAERS ID: 1656176 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Chest pain, Diarrhoea, Ear pain, Electrocardiogram normal, Eye movement disorder, Headache, Lymphadenopathy, Nausea, Neuralgia, Pain in extremity
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Ocular motility disorders (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Bananas, Canteloupe
Diagnostic Lab Data: EKG in ER on 8/26/21 - normal - unable to get appointment to see provider - hospitals full. I have called and requested to be seen by my PCP. Waiting for a call back.
CDC Split Type:

Write-up: 8/25/21 - Burning sensation clear down left arm within 5 minutes of injection, headache starting around 6:00 PM. 8/26/21 - Headache to the point of not being able to open eyes. Pain down both legs. Lymph nodes in groin swollen to size of golf balls, chest pain 8/27/21 - Continued headache, pain in left ear (sharp stabbing feeling), nausea, diarrhea, what feels like nerve pain in legs (touch to thigh creates pain in shin/foot) 8/28/21 - Continued headache, pain in left ear, nausea, diarrhea, same nerve pain in legs 8/29/21 - Continued headache, pain in left ear, nausea, diarrhea, same nerve pain in legs 8/30/21 - Continued headache, pain in left ear, nausea, diarrhea, same nerve pain in legs


VAERS ID: 1656202 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Neck pain, Pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, 25mg 2x daily
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Penicillan
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pain under my left arm and down through my left arm, eventually moving into my chest and into the right side of my neck. It seemed to be in my glands.


VAERS ID: 1656244 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Headache, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Shingles shot.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache, pens and needles all over the body.


VAERS ID: 1656253 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-07
Onset:2021-08-25
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

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

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

Write-up: Date Tested/Results: 8/28/21, POSITIVE Covid-19 Vaccine Yes/No: Yes Date of last dose: 1/7/21 8/30: EE still symptomatic. Has a fever, cough, fatigue, congestion. EE reported that she is covid positive, 8/28/21. Discussed that she will need to quarantine x10 days since s/s first appeared and 24 hrs pased since last fever without fever reducing medications. EE instructed to call hotline back after she is released from quarantine. DOH to notify EE as well. EE will need to clear with clinic when cleared from quarantine and no longer having symptoms.


VAERS ID: 1656264 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-29
Onset:2021-08-25
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Pharmacy       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No prescriptions documented
Current Illness: None documented
Preexisting Conditions: Ventricular premature beats
Allergies: Penicillin - Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID-19 after being fully vaccinated


VAERS ID: 1656314 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-06-30
Onset:2021-08-25
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 AR / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram normal, Dizziness, Headache, Hypotension, Laboratory test normal, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), 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), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CAT Scan 8/27/21 negative Labs 8/20/21 normal values
CDC Split Type:

Write-up: Dizzy, fainting, headaches, nausea, low blood pressure


VAERS ID: 1656372 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 3 LA / IM
FLUA3: INFLUENZA (SEASONAL) (FLUAD) / NOVARTIS VACCINES AND DIAGNOSTICS 312832 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Interchange of vaccine products, Seizure
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Medication errors (broad), Hypoglycaemia (broad)

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

Write-up: According to son, mom began to feel bad in the evening after receiving both the Fluad flu vaccine and Moderna COVID vaccine on the same day. He did not give us any information than that at the time and hung up on the technician before she could get any information. When he contacted our corporate office, he stated she was having seizures and in the hospital.


VAERS ID: 1656379 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Cough, Dizziness, Full blood count, Mast cell activation syndrome, Metabolic function test, Secretion discharge, Tremor, Urinary incontinence
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: On Additional Information Page
Current Illness: NONE
Preexisting Conditions: Mast Cell Activation Syndrome
Allergies: On Additional Information Page
Diagnostic Lab Data: CBC Panel, Comprehensive Metabolic Panel 08/25/2021
CDC Split Type:

Write-up: Light-headed and slightly shaky approximately 5 minutes after receiving vaccine, so once I got my card we left to go immediately to the Emergency Room, approximately 10 minutes away. The symptoms progressed including strong tremors, mucus production, coughing and loss of bladder. I administered an EpiPen in the vehicle. I was immediately triaged at hospital and admitted for observation. No additional medications were administered. I was under observation for four (4) hours and discharged, making sure I had additional EpiPens. Since vaccination, I have been extremely reactive in a Mast Cell Flare, and am taking 50 mg of Prednisone, Benadryl and Nebulizer as needed.


VAERS ID: 1656440 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 LA / IM

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

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

Write-up: Patient adversely received Moderna as dose #2 in COVID-19 vaccination series. Remained asymptomatic while in observation area. Spoke with patient''s mother on 8/26/21, 1 day post vaccination, patient c/o mild soreness at injection site.


VAERS ID: 1656467 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-01
Onset:2021-08-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simponi, methotrexate, protonix, propranolol, rizatriptatan, ondansetron wellbutrin, trazadone
Current Illness: none
Preexisting Conditions: Rheumatoid Arthritis
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1656476 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Generalised tonic-clonic seizure, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: sertraline tablets: 1 daily Prenate enhance capsule: 1 daily
Current Illness: approximately 6 weeks post-partum
Preexisting Conditions:
Allergies: Latex Antihistamines
Diagnostic Lab Data: levetiracetam
CDC Split Type:

Write-up: Grand Mal seizure resulting in hospitalization. Immediately proceeding the seizure, patient experienced rash and itching on upper arms. No previous history of seizures.


VAERS ID: 1656516 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-03
Onset:2021-08-25
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Headache, Pain, Pyrexia, SARS-CoV-2 test positive, Throat irritation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: *sertraline 100 mg tablet * fluticasone propion-salmeteroL 250-50 mcg/dose diskus 1 puff 2 (two) times a day * albuterol 90 mcg/actuation inhaler * olmesartan-hydroCHLOROthiazide 20-12.5 mg per tablet * glimepiride 4 mg tablet 2x daily *
Current Illness: None
Preexisting Conditions: Asthma, hypertension, Diabetes Mellitus,
Allergies: None
Diagnostic Lab Data: SARS-CoV2-RNA, TMA SWAB, NASOPHARYNX Detected
CDC Split Type:

Write-up: Positive test for COVID-19. Symptoms: scratchy throat, fever, headache, body aches


VAERS ID: 1656558 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-25
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01121A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Erythema, Injection site rash, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan 100 mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that she received bumps around the injection site. The second shot cause a red marks on legs and the booster gave her a red itich rash all over.


VAERS ID: 1656574 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: Administration Error - Diluted Incorrectly Patient received Pfizer Vaccine on 8/25/2021 that was inadvertently, serially diluted. Per CDC''s interim clinical considerations, advised to be revaccinated ASAP in opposite arm.


VAERS ID: 1656576 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: Administration Error - Diluted Incorrectly Patient received Pfizer Vaccine on 8/25/2021 that was inadvertently, serially diluted. Per CDC''s interim clinical considerations, advised to be revaccinated ASAP in opposite arm.


VAERS ID: 1656588 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Atorvastatin, Ozempic, Vitamin C, D3, Zinc
Current Illness: none
Preexisting Conditions: asthma, type 2 diabetes
Allergies: shell fish, iodine, avocadoes, morphine, pennecillin, codeine, most animals, pollen, dust
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash, hives. popping up every day since 2 days after shot. Its been 8 days and i''m still getting these hives popping up and itching each day.


VAERS ID: 1656780 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-04
Onset:2021-08-25
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chest discomfort, Dyspnoea, Maternal exposure during pregnancy, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test positive, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Rapid Test for COVID 26th, at Pharmacy
CDC Split Type: vsafe

Write-up: I kind of started feeling like I was having some allergies and a stuffy nose, but it wasn''t that bad. That was starting on the 21st maybe. On the 25th, I woke up and I couldn''t really breathe nose was completely clogged; postnasal drip was a lot (really bad) and making my throat sore. The 26th, I woke up feeling even worse. I had a rapid test done at Pharmacy and it came back positive for COVID. Doctor call recommended OTC cold medicine that doesn''t contain decongestant, so I have been taking daytime and nighttime Robitussin. I completely lost sense of taste and smell. I do have a heavy chest and the congestion is making it kind of hard to breathe. Pregnancy history: I have been pregnant twice before had one miscarriage and one abortion. Estimated date of delivery for this pregnancy is November 5, 2021.


VAERS ID: 1656790 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3282 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Gait inability, Pain in extremity, Thrombosis
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Testosterone Cypionate 200 mg/mL Injection
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called on 8/30/21 to let us know that after his shot on 8/25/21, his calf started hurting. Then today, the patient could not walk because of the pain in his lower leg. According to the patient the pain had just continued to increase until he couldn''t walk. When the patient called Pharmacy he was instructed to go to an Urgent Care, ER, or Primary Care Physician. He went to the Urgent Care where he was seen by a Doctor C. and they found a blood clot in his calf. He was prescribed Eliquis for the blood clot on 8/30/21. I reached out to the Urgent Care and was left on hold for 10+ minutes.


VAERS ID: 1656811 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-09
Onset:2021-08-25
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray, Dizziness, Electrocardiogram, Nausea, Spinal pain, Sudden hearing loss
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: N/a
Diagnostic Lab Data: 8/25/2021 ER took X-rays and EKG Was in the ER from 5pm to 10ish pm Steroids were given to me - and still am having side effects
CDC Split Type:

Write-up: Sudden hearing loss in the right ear V?rtigo Dizzy Nauseous Ended up in the ER Chest X-rays and EkG were performed


VAERS ID: 1656820 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Adnexa uteri pain, Burning sensation, Chest discomfort, Chest pain, Discomfort, Dizziness, Fatigue, Feeling cold, Headache, Heart rate irregular, Investigation, Musculoskeletal stiffness, Myalgia, Pain in extremity, Paraesthesia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol 500mg, Women''s multivitamin
Current Illness: n/a
Preexisting Conditions: Asthma and Anemia
Allergies: Aspirin and Ibuprofen
Diagnostic Lab Data: Ongoing tests waiting for results.
CDC Split Type:

Write-up: I experienced tingling and burning in left arm along with muscle soreness and stiffness.Also, had head-ache, tingling and cool sensation in brain, irregular heart beat, lightheaded, extreme fatigue for 2-3 days. Also, 4 hours after the shot had slight heaviness and pressure in chest and lungs and I had to sleep elevated. On the second day in the morning had chest pain off and on,fatigue and muscle soreness in left arm. On the third day experienced fatigue, chest pain off and on and pain in the right abdomen/ovary.


VAERS ID: 1656995 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 LA / IM

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

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

Write-up: Patient was administered 1 of 2 series of the Moderna Covid19 vaccine. it is our understanding that Moderna is not approved for use under the age of 18.


VAERS ID: 1657020 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Headache, Injection site pain, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Started with fever and body aches almost 12 hours after vaccine, then a few hours later head ache and nausea. 3 days after vaccine noticed chest pain and shortness of breath. 5 days after vaccine started feeling stinging pains at injection spot. 6 days later stinging pain has spread to my legs.


VAERS ID: 1657043 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-15
Onset:2021-08-25
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, COVID-19, Cough, Dyspnoea, Electrocardiogram, Malaise, Neck pain, Pain, Pain in extremity, SARS-CoV-2 antibody test, SARS-CoV-2 test, Sinus operation, Sneezing, Urine analysis
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol Sulfate Inhaler; Aleve; Arthro 7; Atrovent Inhaler; Celexa; Lisinopril/HCTZ; Micronor Birth Control; Tizanidine; Tylenol; Women''s Multivitamin
Current Illness: N/A
Preexisting Conditions: Asthma; High Blood Pressure; Bipolar II; PTSD
Allergies: N/A
Diagnostic Lab Data: Covid Antibody, Covid Antigen, EKG, Urine Test
CDC Split Type:

Write-up: I received My Two-dose Pfizer Covid Vaccines from Pharmacy. I had Normal symptoms at first, but Now as of Last Week, August 25th, 2021, I''ve started feeling Extremely sick: Nose leaking clear liquid like water, constant sneezing, a Hatd, Dry cough that shoots pain from My Lower Back all the way up to My Neck. I also have Extreme Back Pain & Pain in Both Legs. I was having so much Difficulty breathing, I kept pumping My Atrovent Inhaler every two hours. My Pain Pills had already stopped working by then & on Saturday, August 28th, I called 911 because I was having even more Trouble breathing. I was taken to Hospital and given Tests & My Breathing Treatment and Now I have Covid for the First Time. Which I doubt Understand because I''m Fully Vaccinated for Covid as well as My other Vaccinations.


VAERS ID: 1657254 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Entyvio
Current Illness: Sinus infection a few weeks prior
Preexisting Conditions: Ulcerative Colitis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Looks like I have a golf ball under my skin at the site of injection due to extreme swelling, which has still not gone away 7 days later. Was very red at the site, but that has since pretty much fully gone away.


VAERS ID: 1657258 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-09
Onset:2021-08-25
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RA7484 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Parosmia, Taste disorder
SMQs:, Taste and smell disorders (narrow), 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: Levothyroxine, fish oil, prenatal, D3, adrenal health support, CoQ10, Vitex, Myo & d-chiro inositol, berberine,
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: Pollen
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Loss of taste and smell of some foods and smells 14 days after first dose. Heightened sense of vinegar/metallic scents. Loss of flavor. IE can taste sweetness but no differentiation between flavors like chocolate or vanilla.


VAERS ID: 1657259 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-25
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dehydration, Muscular weakness, Pyrexia, Vestibular migraine
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C (1gram/day)
Current Illness:
Preexisting Conditions: Overweight, osteopenia in legs
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vestibular migraines lasting several days, rare chest tightness, muscle weakness, dehydration, alternating chills and fever at night without changes to sleep arrangements


VAERS ID: 1657441 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 02SC2M / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 03/14/2021, Moderna, Significant lymph node swelling left side
Other Medications: Allegra, Magnesium, D3, Acid, Cranberry, Biosill, C0Q10, Vitamin K 1&2, Tumeric, Glucosimine,
Current Illness: none
Preexisting Conditions: Breast Cancer Survivor
Allergies: Sulfa Drugs, Codeine, Imodium, Nitrous oxide
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Swollen lymph nodes in arm, arm pit, and left breast. Treatment included lymphatic massage and exercise


VAERS ID: 1657447 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Coprolalia, Head banging, Screaming, Tic, Tinnitus
SMQs:, Dyskinesia (broad), Dystonia (broad), Hostility/aggression (broad), Hearing impairment (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: Sertraline; Aripiprazole; Lamictal; Clonidine; Dexmethylphenidate; Clonidine; Guanfacine; Folic Acid
Current Illness:
Preexisting Conditions: Tourette''s; Photosensitive epilepsy; ADHD
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 3-4 hours of severe physical tics accompanied by non-stop coprolalia, head banging and screaming. Complaining of ringing in ears and aural sensitivity. Episode receded, but significant tics occurred the next day as well.


VAERS ID: 1657564 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Pain in left arm at injection site. Pain has gotten worse on day 5.


VAERS ID: 1657570 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Epistaxis, Headache, Injection site bruising
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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: BENADRYL; ADVIL DUAL ACTION
Current Illness: Under evaluation for low thyroid levels
Preexisting Conditions: Fibromyalgia; Asthma; Sinusitis; Allergies; Depression; Anxiety; Sleep Disorder; Neuropathy; Hypertension; Sciatica Gastroparesis.
Allergies: Sulfa; Seafood; Environmental allergies; Ant stings; Mushrooms
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense headache on top of the head, small bruise (first it was like a dot) on the left arm by injection site. Large bruise on the right hand, nasal bleeding.


VAERS ID: 1658103 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-22
Onset:2021-08-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

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

Write-up: heart palpitations, arrhythmia


VAERS ID: 1658448 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Headache, Lethargy, Lymph node pain, Lymphadenopathy, Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: swelling and pain in lymph nodes under armpit and down to breast, some swelling still present a week later generalized aching in joints discomfort weakness lethargy, headache discomfort in left shoulder area down the full extremity


VAERS ID: 1658478 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-01
Onset:2021-08-25
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Fall, Feeling abnormal, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Pseudomembranous colitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: CAD, Hypothyroid, Ischemic cardiomyopathy, Asthma, CKD, Hx of CABG, type 2 diabetes, HTN, Dyslipidemia
Allergies: No known allergies
Diagnostic Lab Data: COVID positive 8/25/21
CDC Split Type:

Write-up: Patient admitted to hospital with positive COVID test on 8/25/21. States he felt bad for 3 weeks with diarrhea, multiple falls. O2 on room air was 90% on arrival.


VAERS ID: 1658500 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Premature delivery, Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: prenatal vitamins Irion supplements
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: I went into labor 4 hours after the vaccine. I delivery my child 1:40AM on 8/26/2021. My baby weight 3IBS and 13 ounces. The estimated due was 10/28/2021.


VAERS ID: 1658557 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-08-25
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Anaemia macrocytic, COVID-19, SARS-CoV-2 test positive, Sexually inappropriate behaviour, Vitamin B12 decreased
SMQs:, Haematopoietic erythropenia (narrow), Dementia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Current Facility-Administered Medications Medication Dose Route Frequency Last Rate ? fluticasone (FLONASE) nasal spray SUSP 1 Spray 1 Spray Both Nares DAILY ? QUEtiapine (SEROquel) tablet 50 mg 50 mg Oral DAILY ? QUEtiapine (SEROquel
Current Illness: Past Medical History: Diagnosis Date ? Alzheimer disease (CMS/HCC) ? Anemia ? Anxiety ? Dementia (CMS/HCC) ? GERD (gastroesophageal reflux disease) ? Herpes simplex type 1 infection ? Hyperlipidemia ? Hypothyroidism ? IBS (irritable bowel syndrome)
Preexisting Conditions: Past Medical History: Diagnosis Date ? Alzheimer disease (CMS/HCC) ? Anemia ? Anxiety ? Dementia (CMS/HCC) ? GERD (gastroesophageal reflux disease) ? Herpes simplex type 1 infection ? Hyperlipidemia ? Hypothyroidism ? IBS (irritable bowel syndrome)
Allergies: Medication Administration Record Allergies reviewed. Klonopin [clonazepam
Diagnostic Lab Data: 1. COVID19 positive- negative PCR 8/13, positive PCR 8/24- pt is asymptomatic. Pt immunized on 3/10 and 3/31 with Pfizer COVID19 vaccine. Repeat PCR ordered. 2. Low B12 with negative PA workup- continue PO B12 3. Hypothyroidism 4. Dementia with behavioral disturbance 5. HLD 6. Macrocytic anemia- Hgb stable 7. H/o GAD 8. H/o IBS 9. Await COVID antibodies 10. Await repeat PCR, if negative, pt can return to facility. 11. Patient unable to go to facility until 10 day quarantine is completed if repeat test is positive 12. DC planning- SAR vs. facility
CDC Split Type:

Write-up: This is a 83y.o. male with a PMH as below who was admitted to 4N due to sexually inappropriate behavior. Pt was being prepared for discharge and subsequent COVID19 PCR testing was positive. Pt is asymptomatic. Spoke with daughter and she confirmed patient was vaccinated for COVID19 on 3/10 and 3/31. Pt received the Pfizer vaccine. Pt was evaluated this morning. Pt denies any symptoms. Pt denies any CP/sob. No n/v/d. No fever or chills.


VAERS ID: 1658574 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-08-25
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Feeling abnormal, Infection, Nasal congestion, Nausea, Productive cough, Vomiting
SMQs:, Acute pancreatitis (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient''s Medications New Prescriptions No medications on file Previous Medications ACETAMINOPHEN (TYLENOL) 325 MG PO TAB take 2 Tabs by mouth every 6 hours. ALBUTEROL (PROVENTIL, VENTOLIN, PROAIR) HFA 108 (90 BASE) MCG/ACT INHAL
Current Illness: Arthritis ? Asthma ? Chronic back pain ? Dyslipidemia ? GERD (gastroesophageal reflux disease) ? Hepatitis 20 yrs. + A ? Hyperlipidemia ? Hypertension ? Neuropathy back/scapula area. ? Obstructive sleep apnea Uses Cpap machine. ? Primary osteoarthritis of left hip ? Stroke shown in MRI. ? TIA (transient ischemic attack)
Preexisting Conditions: Arthritis ? Asthma ? Chronic back pain ? Dyslipidemia ? GERD (gastroesophageal reflux disease) ? Hepatitis 20 yrs. + A ? Hyperlipidemia ? Hypertension ? Neuropathy back/scapula area. ? Obstructive sleep apnea Uses Cpap machine. ? Primary osteoarthritis of left hip ? Stroke shown in MRI. ? TIA (transient ischemic attack)
Allergies: Allergies Allergen Reactions ? Cephalexin Acute renal failure and GI Distress ? Decadron [Dexamethasone] Rash/Itching ? Erythromycin Hives "it tears my insides up" ? Gentamicin Swelling, generalized Toe swelling and redness ? Lamisil [Terbinafine] Rash/Itching ? Levofloxacin Swelling, lips/throat/tongue ? Methylprednisolone Rash/Itching ? Prednisone Rash/Itching ? Toviaz [Fesoterodine Fumarate Er] Hives ? Cleocin [Clindamycin] GI Distress ? Codeine Anxiety Hyper/restless ? Lamotrigine Other Can not recall
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 75-year-old female with history of asthma and hypertension who presents with a chief complaint of nausea and diarrhea. Patient states for the past week she has felt "lousy." She describes nasal congestion, productive cough, nausea, and diarrhea. She states she had a couple episodes of emesis which has since resolved. She is most bothered by diarrhea which she states has been "pouring out of her"for the past several days. She has been able to drink water but has not had much of an appetite. Denies fevers. Denies shortness of breath or chest pain. She went to her PCP who prescribed for azithromycin for an unspecified infection per patient. Patient denies sick contacts. She lives in a senior community. She was fully vaccinated for COVID with last dose in March.


VAERS ID: 1658639 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-21
Onset:2021-08-25
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: SARS-CoV-2 test, Sinus congestion
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: PMC molecular COVID-19 Rapid test
CDC Split Type:

Write-up: sinus congestion


VAERS ID: 1658641 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Florida  
Vaccinated:2020-12-31
Onset:2021-08-25
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Sepsis
SMQs:, Infective pneumonia (broad), Sepsis (narrow), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted for COVID/sepsis 8/25/21, discharged 8/26/21. Treated with dexamethasone IV daily.


VAERS ID: 1658654 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-08-25
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation
SMQs:, Supraventricular tachyarrhythmias (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: Hospitalization for AFIB/Rule-out COVID PNEUMONIA. Treated with dexamethasone 6 mg IV daily


VAERS ID: 1658671 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-11
Onset:2021-08-25
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization for COVID Pneumonia 8/25-8/29/2021. Treated with dexamethasone IV daily and Remdesivir


VAERS ID: 1658794 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2020-12-21
Onset:2021-08-25
   Days after vaccination:247
Submitted: 0000-00-00
Entered: 2021-08-31
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: PCR Test
CDC Split Type:

Write-up: Employee tested positive for COVID 19 after being vaccinated.


VAERS ID: 1658799 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-21
Onset:2021-08-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood culture negative, C-reactive protein normal, Chest X-ray normal, Dyspnoea, Full blood count normal, Legionella test, Pyrexia, SARS-CoV-2 test negative, Urine analysis normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: held methotrexate since 08/18/2021 in prep for vaccine, held enbrel, on synthroid and hormones menopause
Current Illness: on going RA controlled with methotrexate and enbrel
Preexisting Conditions: RA, hypothyroid
Allergies: none
Diagnostic Lab Data: twice had cbc ,crp ,cxr, blood cultures, chemistry panel, urine, legionella x1 , covid x3 all negative no sore throat , no nasal drainage
CDC Split Type:

Write-up: I went off enbrel/methotrexate 8/18 knowing i wanted booster #3 on 8/21. I got vaccine 8/21, next day got a fever which i expected and was happy to get, Next 2 days I worked and was fine, on 8/25 i started running fevers of 101-102.2 consistantly with no other symptoms, went to Dr had labs, all labs were normal, on Saturday 8/28Ii went to ER with temp 101.9 heart rate 144 covid negative all labs including cxr neg, gave me IV ROCEPHIN & ZITHROMAX went home on doxycycline , Sunday woke up no longer fevering but short of breath, went to Dr on Monday 8/30 he put me on steroids tapered dose and I feel really good today. I am not saying this is the vaccine, I''m not sure what the window for adverse effects is. I wanted it badly as I am a nurse as well but for data''s sake this is interesting, it did happen just 4 days after vaccine and all labs including xray were negative, also had neg blood cultures. not looking for compensation just to add to your data for #3 booster if it applies, still glad I got it, sad i had to take steroids but it was 9 days after vaccine so hopefully that wont hurt it any.


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